The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery

Oliver G.S. Ayling; Tamir Ailon; John T. Street; Nicolas Dea; Greg McIntosh; Edward Abraham; W. Bradly Jacobs; Alex Soroceanu; Michael G. Johnson; Jerome Paquet; Parham Rasoulinejad; Phillipe Phan; Albert Yee; Sean Christie; Andrew Nataraj; R. Andrew Glennie; Hamilton Hall; Neil Manson; Y. Raja Rampersaud; Kenneth Thomas; Charles G. Fisher

doi:10.1093/neuros/nyaa427

The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery

Oliver G.S. Ayling, Tamir Ailon, John T. Street, Nicolas Dea, Greg McIntosh, Edward Abraham, W. Bradly Jacobs, Alex Soroceanu, Michael G. Johnson, Jerome Paquet, Parham Rasoulinejad, Phillipe Phan, Albert Yee, Sean Christie, Andrew Nataraj, R. Andrew Glennie, Hamilton Hall, Neil Manson, Y. Raja Rampersaud, Kenneth ThomasCharles G. Fisher

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

BACKGROUND: Perioperative adverse events (AEs) lead to patient disappointment and greater costs. There is a paucity of data on how AEs affect long-term outcomes. OBJECTIVE: To examine perioperative AEs and their impact on outcome after lumbar spine surgery. METHODS: A total of 3556 consecutive patients undergoing surgery for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and Research Network were analyzed. AEs were defined using the validated Spine AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS: AEs occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. Patients with major AEs had worse ODI scores and did not reach minimum clinically important differences at 2 yr (no AE: 25.7 ± 19.2, major: 36.4 ± 19.1, P <. 001). Major AEs were associated with worse ODI scores on multivariable linear regression (P =. 011). PCS scores were lower after major AEs (43.8 ± 9.5, vs 37.7 ± 20.3, P =. 002). On VAS leg and back and EQ5D, the 2-yr outcomes were significantly different between the major and no AE groups (<0.01), but these differences were small (VAS leg: 3.4 ± 3.0 vs 4.0 ± 3.3; VAS back: 3.5 ± 2.7 vs 4.5 ± 2.6; EQ5D: 0.75 ± 0.2 vs 0.64 ± 0.2). SF12 MCS scores were not different. Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P <. 05). CONCLUSION: Major AEs after lumbar spine surgery lead to worse functional outcomes and lower satisfaction. This highlights the need to implement strategies aimed at reducing AEs.

Original language	English
Pages (from-to)	420-427
Number of pages	8
Journal	Neurosurgery
Volume	88
Issue number	2
DOIs	https://doi.org/10.1093/neuros/nyaa427
Publication status	Published - Feb 1 2021
Externally published	Yes

Bibliographical note

Publisher Copyright:
Copyright © 2020 by the Congress of Neurological Surgeons.

ASJC Scopus Subject Areas

Surgery
Clinical Neurology

PubMed: MeSH publication types

Journal Article

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10.1093/neuros/nyaa427

Cite this

Ayling, O. G. S., Ailon, T., Street, J. T., Dea, N., McIntosh, G., Abraham, E., Bradly Jacobs, W., Soroceanu, A., Johnson, M. G., Paquet, J., Rasoulinejad, P., Phan, P., Yee, A., Christie, S., Nataraj, A., Andrew Glennie, R., Hall, H., Manson, N., Raja Rampersaud, Y., ... Fisher, C. G. (2021). The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery. Neurosurgery, 88(2), 420-427. https://doi.org/10.1093/neuros/nyaa427

Ayling, OGS, Ailon, T, Street, JT, Dea, N, McIntosh, G, Abraham, E, Bradly Jacobs, W, Soroceanu, A, Johnson, MG, Paquet, J, Rasoulinejad, P, Phan, P, Yee, A, Christie, S, Nataraj, A, Andrew Glennie, R, Hall, H, Manson, N, Raja Rampersaud, Y, Thomas, K & Fisher, CG 2021, 'The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery', Neurosurgery, vol. 88, no. 2, pp. 420-427. https://doi.org/10.1093/neuros/nyaa427

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title = "The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery",

abstract = "BACKGROUND: Perioperative adverse events (AEs) lead to patient disappointment and greater costs. There is a paucity of data on how AEs affect long-term outcomes. OBJECTIVE: To examine perioperative AEs and their impact on outcome after lumbar spine surgery. METHODS: A total of 3556 consecutive patients undergoing surgery for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and Research Network were analyzed. AEs were defined using the validated Spine AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS: AEs occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. Patients with major AEs had worse ODI scores and did not reach minimum clinically important differences at 2 yr (no AE: 25.7 ± 19.2, major: 36.4 ± 19.1, P <. 001). Major AEs were associated with worse ODI scores on multivariable linear regression (P =. 011). PCS scores were lower after major AEs (43.8 ± 9.5, vs 37.7 ± 20.3, P =. 002). On VAS leg and back and EQ5D, the 2-yr outcomes were significantly different between the major and no AE groups (<0.01), but these differences were small (VAS leg: 3.4 ± 3.0 vs 4.0 ± 3.3; VAS back: 3.5 ± 2.7 vs 4.5 ± 2.6; EQ5D: 0.75 ± 0.2 vs 0.64 ± 0.2). SF12 MCS scores were not different. Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P <. 05). CONCLUSION: Major AEs after lumbar spine surgery lead to worse functional outcomes and lower satisfaction. This highlights the need to implement strategies aimed at reducing AEs. ",

author = "Ayling, {Oliver G.S.} and Tamir Ailon and Street, {John T.} and Nicolas Dea and Greg McIntosh and Edward Abraham and {Bradly Jacobs}, W. and Alex Soroceanu and Johnson, {Michael G.} and Jerome Paquet and Parham Rasoulinejad and Phillipe Phan and Albert Yee and Sean Christie and Andrew Nataraj and {Andrew Glennie}, R. and Hamilton Hall and Neil Manson and {Raja Rampersaud}, Y. and Kenneth Thomas and Fisher, {Charles G.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2020 by the Congress of Neurological Surgeons.",

year = "2021",

month = feb,

day = "1",

doi = "10.1093/neuros/nyaa427",

language = "English",

volume = "88",

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T1 - The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery

AU - Ayling, Oliver G.S.

AU - Ailon, Tamir

AU - Street, John T.

AU - Dea, Nicolas

AU - McIntosh, Greg

AU - Abraham, Edward

AU - Bradly Jacobs, W.

AU - Soroceanu, Alex

AU - Johnson, Michael G.

AU - Paquet, Jerome

AU - Rasoulinejad, Parham

AU - Phan, Phillipe

AU - Yee, Albert

AU - Christie, Sean

AU - Nataraj, Andrew

AU - Andrew Glennie, R.

AU - Hall, Hamilton

AU - Manson, Neil

AU - Raja Rampersaud, Y.

AU - Thomas, Kenneth

AU - Fisher, Charles G.

PY - 2021/2/1

Y1 - 2021/2/1

N2 - BACKGROUND: Perioperative adverse events (AEs) lead to patient disappointment and greater costs. There is a paucity of data on how AEs affect long-term outcomes. OBJECTIVE: To examine perioperative AEs and their impact on outcome after lumbar spine surgery. METHODS: A total of 3556 consecutive patients undergoing surgery for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and Research Network were analyzed. AEs were defined using the validated Spine AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS: AEs occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. Patients with major AEs had worse ODI scores and did not reach minimum clinically important differences at 2 yr (no AE: 25.7 ± 19.2, major: 36.4 ± 19.1, P <. 001). Major AEs were associated with worse ODI scores on multivariable linear regression (P =. 011). PCS scores were lower after major AEs (43.8 ± 9.5, vs 37.7 ± 20.3, P =. 002). On VAS leg and back and EQ5D, the 2-yr outcomes were significantly different between the major and no AE groups (<0.01), but these differences were small (VAS leg: 3.4 ± 3.0 vs 4.0 ± 3.3; VAS back: 3.5 ± 2.7 vs 4.5 ± 2.6; EQ5D: 0.75 ± 0.2 vs 0.64 ± 0.2). SF12 MCS scores were not different. Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P <. 05). CONCLUSION: Major AEs after lumbar spine surgery lead to worse functional outcomes and lower satisfaction. This highlights the need to implement strategies aimed at reducing AEs.

AB - BACKGROUND: Perioperative adverse events (AEs) lead to patient disappointment and greater costs. There is a paucity of data on how AEs affect long-term outcomes. OBJECTIVE: To examine perioperative AEs and their impact on outcome after lumbar spine surgery. METHODS: A total of 3556 consecutive patients undergoing surgery for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and Research Network were analyzed. AEs were defined using the validated Spine AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS: AEs occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. Patients with major AEs had worse ODI scores and did not reach minimum clinically important differences at 2 yr (no AE: 25.7 ± 19.2, major: 36.4 ± 19.1, P <. 001). Major AEs were associated with worse ODI scores on multivariable linear regression (P =. 011). PCS scores were lower after major AEs (43.8 ± 9.5, vs 37.7 ± 20.3, P =. 002). On VAS leg and back and EQ5D, the 2-yr outcomes were significantly different between the major and no AE groups (<0.01), but these differences were small (VAS leg: 3.4 ± 3.0 vs 4.0 ± 3.3; VAS back: 3.5 ± 2.7 vs 4.5 ± 2.6; EQ5D: 0.75 ± 0.2 vs 0.64 ± 0.2). SF12 MCS scores were not different. Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P <. 05). CONCLUSION: Major AEs after lumbar spine surgery lead to worse functional outcomes and lower satisfaction. This highlights the need to implement strategies aimed at reducing AEs.

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The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes after Lumbar Spine Surgery

Abstract

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