Surgical Complications in Intradural Extramedullary Spinal Cord Tumors - An ACS-NSQIP Analysis of Spinal Cord Level and Malignancy
| Autor: | Darian R. Esfahani, Ankit I. Mehta, Steven Denyer, Tania M. Aguilar, Abhiraj D. Bhimani, Jack Zakrzewski |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Malignancy Patient Readmission Thoracic Vertebrae Intraspinal Neoplasm 03 medical and health sciences Young Adult 0302 clinical medicine Lumbar Postoperative Complications Risk Factors Diabetes mellitus medicine Humans Prospective Studies Spinal Cord Neoplasms Aged Retrospective Studies Aged 80 and over Lumbar Vertebrae business.industry Middle Aged medicine.disease Spinal cord Surgery medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Cohort Cervical Vertebrae Female Neurology (clinical) Neurosurgery Complication business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. 117 |
| ISSN: | 1878-8769 |
| Popis: | Background Intradural extramedullary (IDEM) spinal cord tumors account for two-thirds of all intraspinal neoplasms. Surgery for IDEM tumors carries risks for many different complications, which to date have been poorly described and quantified. In this study, we better characterize risk factors and complications for IDEM tumors, stratifying patients by spinal cord level and malignancy. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to determine 30-day outcomes following surgery for IDEM tumors between 2005 and 2016. Patients with cervical, thoracic, and lumbar tumors were compared in terms of demographics, comorbidities, and postoperative complications. A similar analysis was performed comparing patients with benign and malignant tumors. Results A total of 991 patients with IDEM tumors were identified in the cohort. The majority of tumors were thoracic (44.3%), followed by lumbar (35.4%) and cervical (20.3%). Only 6.3% of patients were readmitted within 30 days, 4.2% returned to the operating room, and 1.0% died. Significant associations were noted between spinal cord level and patient sex, age, functional status, American Society of Anesthesiologists (ASA) classification, prevalence of diabetes and hypertension, and risk of developing pneumonia. Benign and malignant tumors differed by patient sex, baseline ASA class, risk of return to the operating room, mortality, and likelihood of transfusion. Conclusions IDEM tumors are common and carry surgical risks, with different complication profiles for tumors at different spinal levels and degrees of malignancy. With definitive risk factors and outcomes, the ACS-NSQIP cohort provides a snapshot of national neurosurgery trends and outcomes in contemporary IDEM surgery. |
| Databáze: | OpenAIRE |
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