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Age, operative time and two-stage surgery linked with increased perioperative complications
Researchers of this literature review found older patients, patients who undergo a longer operation and those who have a two-stage surgery to treat cervical spondylotic myelopathy are at a higher risk of perioperative complications.
Researchers conducted a systematic review of the literature and searched MEDLINE, MEDLINE in Process, EMBASE and the Cochrane Central Register of Controlled Trials from 1948 to September of 2013 to identify cohort studies designed to evaluate predictors of complications. Intervention studies conducted to compare different surgical approaches for cervical spondylotic myelopathy were also included.
Of the 5,472 citations, 60 studies met the inclusion criteria for the study. In total, 36 prognostic cohort studies and 28 comparative intervention studies were included.
Researchers reviewed the studies and found there was high evidence to suggest older patients are at a greater risk for perioperative complications. However, researchers also found patient body mass, comorbidities, smoking status, baseline severity scores and duration of symptoms are not predictive of complications.
“With respect to surgical factors, a longer operative duration is associated with greater perioperative complication rates. Duration of surgery may be a surrogate for case complexity. Therefore, we do not recommend surgeons speed up surgery to prevent complications but rather identify complex cases, anticipate complications and plan accordingly. A two-stage anteroposterior surgery is predictive of major complications; similarly, this factor may reflect greater degenerative pathology and increased case complexity,” researchers wrote in the study. – by Robert Linnehan.
Disclosure: The researchers report no relevant financial disclosures.