Artikel
Surgical and general complication rates in the four largest diagnosis and treatment subgroups of patients in the German Spine Registry
Suche in Medline nach
Autoren
-
Nikolaos Bagias
- Abteilung für Neurochirurgie, Evangelische Krankenhaus, Oldenburg, Oldenburg, Germany
-
Wolfgang Börm
- Abteilung für Neurochirurgie, Diakonissenkrankenhaus, Flensburg, Germany
-
Marcus Richter
- Wirbelsäulenzentrum, St. Joseph Krankenhaus, Wiesbaden, Germany
-
E. Aghayev
- Institut für Evaluative Forschung in der Medizin, Universität Bern, Bern, Switzerland
-
Frerk Meyer
- Abteilung für Neurochirurgie, Evangelische Krankenhaus, Oldenburg, Oldenburg, Germany
-
the German Spine Register Study Group
| Veröffentlicht: | 8. Juni 2016 |
|---|
Gliederung
Text
Objective: The question in spine surgery “Is it safe?” is of outmost importance. The objective of the study was to create reference values for surgical and general complications in the German Spine Registry and assess their variation between centers.
Method: Until Nov 2015 14743 surgery forms were collected, and the following 4 largest patient subgroups were selected, while excluding centers with <5 cases per diagnosis and treatment: 1) lumbar degenerative spondylolisthesis treated by instrumented fusion (n=981), 2) lumbar disc herniation treated by decompression alone (n=2347), 3) lumbar spinal stenosis without spondylolisthesis treated by decompression alone (n=1812), or by instrumented fusion (n=276). Perioperative surgical and general complication rates with 95% confidence intervals (95%CI) per center were studied in funnel plots accounting for the center’s caseload. The average complication rates per group with standard deviation (SD) were calculated and the number of centers above and below the average with 95%CI assessed.
Results: On the average 21 centers contributed 47 cases (range 8-222) in group 1 with an average surgical complication rate of 17.2% (SD 9.2; range 7.1-37.5%), and a general complication rate of 6.8% (SD 7.3; range 0-21.4%). 25 centers reported an average of 94 cases (range 7-532) in group 2 with an average surgical complication rate of 8.5% (SD 7.7; range 0-25.6%), and a general complication rate of 1.4% (SD 1.2; range 0-4.7%). 24 centers collected an average of 76 cases (range 5-324) in group 3 with a surgical complication rate of 12.3% (SD 8.4; range 3.9-34.8%), and a general complication rate of 3.4% (SD 3.3; range 0-10.0%). 16 centers reported an average of 17 cases (range 5-52) in group 4 with an average surgical complication rate of 18.8% (SD 7.6; range 0-34.6%), and a general complication rate of 10.8% (SD 7.2; range 0-20.0%). Two centers in group 2 and one in group 3 had higher (35.3%, 25.6% and 34.8%, respectively) surgical complication rates than the average of 95%CI. Otherwise, all centers were within the average.
Conclusions: The reported surgical and general complication rates can be considered as the reference values based on the German Spine Registry data. There were no signs of significant underreporting of complications, as none of the centers had a complication rate below the average of 95%CI. Relatively high variations of surgical complication rates overall and of general complication rates in instrumented fusion between centers were observed.
