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A predictive model of complications after spine surgery: the National Surgical Quality Improvement Program (NSQIP) 2005–2010
Conclusions: Our model can provide individualized estimates of the risks of postoperative complications based on preoperative conditions, and can potentially be used as an adjunct in decision-making for spine surgery.
Source: The Spine Journal - November 8, 2013 Category: Orthopaedics Authors: Kimon Bekelis, Atman Desai, Samuel F. Bakhoum, Symeon Missios Tags: Clinical Studies Source Type: research

Post-traumatic thrombo-embolic complications in polytrauma patients
Conclusion TE complications were associated with longer ICU and hospital stay as well as a higher mortality. Overall, age and repeated operations were the most important risk factors for the development of TE events.
Source: International Orthopaedics - February 18, 2015 Category: Orthopaedics Source Type: research

Reduced short-term complications and mortality following Enhanced Recovery primary hip and knee arthroplasty: results from 6,000 consecutive procedures.
Abstract Background and purpose Enhanced Recovery (ER) is a well-established multidisciplinary strategy in lower limb arthroplasty and was introduced in our department in May 2008. This retrospective study reviews short-term outcomes in a consecutive unselected series of 3,000 procedures (the "ER" group), and compares them to a numerically comparable cohort that had been operated on previously using a traditional protocol (the "Trad" group). Methods Prospectively collected data on surgical endpoints (length of stay (LOS), return to theater (RTT), re-admission, and 30- and 90-day mortality) and medical complication...
Source: Acta Orthopaedica - December 20, 2013 Category: Orthopaedics Authors: Khan SK, Malviya A, Muller SD, Carluke I, Partington PF, Emmerson KP, Reed MR Tags: Acta Orthop Source Type: research

What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?
CONCLUSIONS: As lengths of hospital stay after TJA continue to decrease, our findings suggest that caution is in order because several acute and immediately life-threatening findings, including myocardial infarction and pulmonary embolism, might occur after discharge. Furthermore, the timing of surgical site infection and sepsis suggests that even the 30-day followup afforded by the ACS-NSQIP may not be sufficient to study the latest occurring adverse events. Additionally, both pulmonary embolism and deep vein thrombosis tend to occur earlier after TKA than THA, and this should guide clinical surveillance efforts in patien...
Source: Clinical Orthopaedics and Related Research - January 3, 2017 Category: Orthopaedics Authors: Bohl DD, Ondeck NT, Basques BA, Levine BR, Grauer JN Tags: Clin Orthop Relat Res Source Type: research

Are Cardiac Complications Associated With Other Adverse Events? A Look at 56,000 Orthopaedic Trauma Patients.
Authors: Yarlagadda M, Shen M, Abraham A, Mousavi I, Sethi MK Abstract The purpose of this study was to identify those complications for which patients with adverse cardiac events are at risk within the 30-day postoperative period following treatment oforthopaedic trauma cases. This was a retrospective cohort study of orthopaedic trauma patients in the United States between 2006 and 2013. A total of 56,336 patients meeting any one of 89 CPT codes in the American College of Surgeons National Surgical Quality Improvement Program database were used. The main outcome measure was myocardial infarction or cardiac arrest ...
Source: Journal of surgical orthopaedic advances - November 30, 2018 Category: Orthopaedics Tags: J Surg Orthop Adv Source Type: research

Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients
CONCLUSION THC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. LEVEL OF EVIDENCE Prognostic study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 23, 2020 Category: Orthopaedics Tags: 2020 EAST PODIUM PAPER Source Type: research

Effect of Antifibrinolytic Therapy on Complications, Thromboembolic Events, Blood Product Utilization, and Fusion in Adult Spinal Deformity Surgery
Conclusion. TXA or EACA use was associated with increased minor intraoperative complications. TXA was associated with decreased major perioperative complications. AF was associated with decreased utilization of blood products without an increased rate of thromboembolic events. Given the nature of this study, transfusion threshold was not standardized. Future studies with rigid criteria for transfusion should be prospectively performed to better evaluate the impact of AF during ASD surgery. Level of Evidence: 3
Source: Spine - July 9, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Risk Factors for 30-Day Unplanned Readmission and Major Perioperative Complications After Spine Fusion Surgery in Adults: A Review of the National Surgical Quality Improvement Program Database
Conclusion. This study provides benchmark rates of 30-day readmission based on diagnosis and procedure codes from a high-quality database for adult spinal fusion patients and showed increased rates of 30-day unplanned readmission and major perioperative complications for patients with specific risk factors. Targeted preoperative planning on modifiable risk factors with proportional reimbursement may promote higher-quality healthcare. Level of Evidence: 3
Source: Spine - October 1, 2016 Category: Orthopaedics Tags: Health Services Research Source Type: research

Medical Complications After Adult Spinal Deformity Surgery: Incidence, Risk Factors, and Clinical Impact
Conclusion. Risk factors for the development of postoperative medical complications after correction of ASD include smoking, hypertension, and duration of symptoms. Patients who have one or more of these risk factors should be identified and informed during informed consent of their increased risks. They should be optimized preoperatively, and followed closely during the postoperative period. Level of Evidence: 3
Source: Spine - November 12, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Spinal Anesthesia in Elderly Patients Undergoing Lumbar Spine Surgery.
Abstract Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 yea...
Source: Orthopedics - December 26, 2016 Category: Orthopaedics Authors: Lessing NL, Edwards CC, Brown CH, Ledford EC, Dean CL, Lin C, Edwards CC Tags: Orthopedics Source Type: research

Coagulation Profile as a Risk Factor for 30-Day Morbidity and Mortality Following Posterior Lumbar Fusion
Study Design. A retrospective cohort study. Objective. The aim of this study was to identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). Summary of Background Data. The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF. Methods. The American College of Surgeons National Surgical Quality Impro...
Source: Spine - June 15, 2017 Category: Orthopaedics Tags: Surgery Source Type: research

Safety of a High-Dose Tranexamic Acid Protocol in Complex Adult Spinal Deformity: Analysis of 100 Consecutive Cases
Conclusions This is the first study to demonstrate the use of high-dose TXA in a complex ASD population. Larger prospective studies are needed to assess the efficacy and safety of high-dose TXA in ASD. Level of Evidence Level IV, therapeutic.
Source: Spine Deformity - November 4, 2017 Category: Orthopaedics Source Type: research

Short-term Medical Complications Following Short Versus Long Cephalomedullary Nails.
Abstract The purpose of this retrospective cohort study was to evaluate whether there is an increased rate of short-term medical complications following short vs long cephalomedullary nails for the treatment of intertrochanteric hip fractures. A total of 899 patients treated surgically with cephalomedullary nails from January 1, 2005, to September 1, 2014, were included. Patients who received short nails (n=334) were older and had a higher incidence of coronary artery disease and diabetes mellitus compared with patients who received long nails (n=565). The incidences of 30-day medical complications, including myoc...
Source: Orthopedics - July 16, 2018 Category: Orthopaedics Authors: Liu J, Frisch NB, Mehran N, Qatu M, Guthrie ST Tags: Orthopedics Source Type: research

The Association of Delirium with Perioperative Complications in Primary Elective Total Hip Arthroplasty.
Conclusions: Delirium is an independent risk factor for major and minor perioperative complications after primary elective THA. PMID: 30174803 [PubMed - in process]
Source: Clinics in Orthopedic Surgery - September 5, 2018 Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research

Comparative Analysis of Short-Term Postoperative Complications in Outpatient Versus Inpatient Total Ankle Arthroplasty: A Database Study
This study evaluated the complication rates in inpatient versus outpatient TAA. It analyzed data from the National Surgical Quality Improvement Program for 591 patients who received TAA. Postoperative complication rates were compared between 66 outpatients and 535 inpatients. Frequencies of the following complications were analyzed: wound complications, pneumonia, hematologic complications (pulmonary embolism and deep vein thrombosis), renal failure, stroke, and return to the operating room within 30days. Unadjusted direct comparisons of the cohorts revealed higher complication rates in the inpatient cohort. Inpatients had...
Source: The Journal of Foot and Ankle Surgery - October 11, 2018 Category: Orthopaedics Source Type: research

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