Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2017
Descriptive analysis of unplanned readmission and reoperation rates after intradural spinal tumor resection.
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Fisahn Christian, Sanders Felipe H, Moisi Marc, Page Jeni, Oakes Peter C, Wingerson Mary, Dettori Joe, Tubbs R Shane, Chamiraju Parthasarathi, Nora Peter, Newell David, Delashaw Johnny, Oskouian Rod J, Chapman Jens R
Аннотация
INTRODUCTION: Spinal cord tumors (SCT) are relatively uncommon and usually require surgical treatment. Readmission within 30days after discharge is an important indicator of health care quality. The aim of this study was to investigate the rates and causes of unplanned readmissions and reoperations after SCT surgery.
METHODS: A retrospective analysis of patients' charts at a single center from May 2007 to September 2015 was completed.
INCLUSION CRITERIA: history of laminectomy with excision of neoplasm in the spinal cord.
EXCLUSION CRITERIA: (1) surgery outside the timeframe; (2) less than 19years old; (3) non-neoplastic intramural pathologies; (4) previous resection at the same location; (5) metastatic lesions.
RESULTS: We found 131 patients that met criteria. Six patients (4.5%) were readmitted within 30days and two within 90days (1.5%). Four underwent reoperation: one for a cerebrospinal fluid leak, two for pseudomenigoceles, and one for repeat laminectomy. Resection of intramedullary tumors resulted in twice the risk of having one or more complications compared to extramedullary tumors (RR 2.0; 95% CI: 1.0-4.2; p=0.057), and nearly four times the risk of having a neurological complication (RR 3.8; 95% CI 1.5-9.5; p=0.005).
CONCLUSION: This study analyzes readmission, reoperation and complication rates for the surgical care of SCT highlighting how SCT surgery is still involved with morbidity in experienced and specialized centers. This information is useful both for health care enhancement projects and for evidence-based patient counseling.
METHODS: A retrospective analysis of patients' charts at a single center from May 2007 to September 2015 was completed.
INCLUSION CRITERIA: history of laminectomy with excision of neoplasm in the spinal cord.
EXCLUSION CRITERIA: (1) surgery outside the timeframe; (2) less than 19years old; (3) non-neoplastic intramural pathologies; (4) previous resection at the same location; (5) metastatic lesions.
RESULTS: We found 131 patients that met criteria. Six patients (4.5%) were readmitted within 30days and two within 90days (1.5%). Four underwent reoperation: one for a cerebrospinal fluid leak, two for pseudomenigoceles, and one for repeat laminectomy. Resection of intramedullary tumors resulted in twice the risk of having one or more complications compared to extramedullary tumors (RR 2.0; 95% CI: 1.0-4.2; p=0.057), and nearly four times the risk of having a neurological complication (RR 3.8; 95% CI 1.5-9.5; p=0.005).
CONCLUSION: This study analyzes readmission, reoperation and complication rates for the surgical care of SCT highlighting how SCT surgery is still involved with morbidity in experienced and specialized centers. This information is useful both for health care enhancement projects and for evidence-based patient counseling.