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. 2018 Jun 1;43(11):E648-E655.
doi: 10.1097/BRS.0000000000002458.

The Impact of Metastatic Spinal Tumor Location on 30-Day Perioperative Mortality and Morbidity After Surgical Decompression

Awais K Hussain  1 , Khushdeep S Vig  1 , Zoe B Cheung  1 , Kevin Phan  1 , Mauricio C Lima  1   2   3 , Jun S Kim  1 , Deepak A Kaji  1 , Varun Arvind  1 , Samuel Kang-Wook Cho  1
Affiliations

The Impact of Metastatic Spinal Tumor Location on 30-Day Perioperative Mortality and Morbidity After Surgical Decompression

Awais K Hussain et al. Spine (Phila Pa 1976). .

Abstract

Study design: A retrospective cohort study from 2011 to 2014 was performed using the American College of Surgeons National Surgical Quality Improvement Program database.

Objective: The purpose of this study was to assess the impact of tumor location in the cervical, thoracic, or lumbosacral spine on 30-day perioperative mortality and morbidity after surgical decompression of metastatic extradural spinal tumors.

Summary of background data: Operative treatment of metastatic spinal tumors involves extensive procedures that are associated with significant complication rates and healthcare costs. Past studies have examined various risk factors for poor clinical outcomes after surgical decompression procedures for spinal tumors, but few studies have specifically investigated the impact of tumor location on perioperative mortality and morbidity.

Methods: We identified 2238 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent laminectomy for excision of metastatic extradural tumors in the cervical, thoracic, or lumbosacral spine. Baseline patient characteristics were collected from the database. Univariate and multivariate regression analyses were performed to examine the association between spinal tumor location and 30-day perioperative mortality and morbidity.

Results: On univariate analysis, cervical spinal tumors were associated with the highest rate of pulmonary complications. Multivariate regression analysis demonstrated that cervical spinal tumors had the highest odds of multiple perioperative complications. However, thoracic spinal tumors were associated with the highest risk of intra- or postoperative blood transfusion. In contrast, patients with metastatic tumors in the lumbosacral spine had lower odds of perioperative mortality, pulmonary complications, and sepsis.

Conclusion: Tumor location is an independent risk factor for perioperative mortality and morbidity after surgical decompression of metastatic spinal tumors. The addition of tumor location to existing prognostic scoring systems may help to improve their predictive accuracy.

Level of evidence: 3.

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References

    1. Wise JJ, Fischgrund JS, Herkowitz HN, et al. Complication, survival rates, and risk factors of surgery for metastatic disease of the spine. Spine (Phila Pa 1976) 1999; 24:1943–1951.
    1. Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 2005; 366:643–648.
    1. Schairer WW, Carrer A, Sing DC, et al. Hospital readmission rates after surgical treatment of primary and metastatic tumors of the spine. Spine (Phila Pa 1976) 2014; 39:1801–1808.
    1. Patil CG, Lad SP, Santarelli J, et al. National inpatient complications and outcomes after surgery for spinal metastasis from 1993–2002. Cancer 2007; 110:625–630.
    1. Elsberg CA. Some aspects of the diagnosis and surgical treatment of tumors of the spinal cord: with a study of the end results in a series of 119 operations. Ann Surg 1925; 81:1057–1073.

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