Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity

Mitsuru Yagi, Naobumi Hosogane, Nobuyuki Fujita, Eijiro Okada, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: ASD surgery improves a patient’s health-related quality of life, but it has a high complication rate. The aim of this study was to create a predictive model for complications after surgical treatment for adult spinal deformity (ASD), using spinal alignment, demographic data, and surgical invasiveness. Methods: This study included 195 surgically treated ASD patients who were > 50 years old and had 2-year follow-up from multicenter database. Variables which included age, gender, BMI, BMD, frailty, fusion level, UIV and LIV, primary or revision surgery, pedicle subtraction osteotomy, spinal alignment, Schwab-SRS type, surgical time, and blood loss were recorded and analyzed at least 2 years after surgery. Decision-making trees for 2-year postoperative complications were constructed and validated by a 7:3 data split for training and testing. External validation was performed for 25 ASD patients who had surgery at a different hospital. Results: Complications developed in 48% of the training samples. Almost half of the complications developed in late post-op period, and implant-related complications were the most common complication at 2 years after surgery. Univariate analyses showed that BMD, frailty, PSO, LIV, PI-LL, and EBL were risk factors for complications. Multivariate analysis showed that low BMD, PI-LL > 30°, and frailty were independent risk factors for complications. In the testing samples, our predictive model was 92% accurate with an area under the receiver operating characteristic curve of 0.963 and 84% accurate in the external validation. Conclusion: A successful model was developed for predicting surgical complications. Our model could inform physicians about the risk of complications in ASD patients in the 2-year postoperative period. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

Original languageEnglish
Pages (from-to)180-187
Number of pages8
JournalEuropean Spine Journal
Volume28
Issue number1
DOIs
Publication statusPublished - 25-01-2019

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Spine
Surgical Blood Loss
Decision Trees
Operative Time
Osteotomy
Reoperation
Postoperative Period
ROC Curve
Decision Making
Multivariate Analysis
Quality of Life
Demography
Databases
Physicians
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Yagi, M., Hosogane, N., Fujita, N., Okada, E., Tsuji, O., Nagoshi, N., ... Watanabe, K. (2019). Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity. European Spine Journal, 28(1), 180-187. https://doi.org/10.1007/s00586-018-5816-5
Yagi, Mitsuru ; Hosogane, Naobumi ; Fujita, Nobuyuki ; Okada, Eijiro ; Tsuji, Osahiko ; Nagoshi, Narihito ; Asazuma, Takashi ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity. In: European Spine Journal. 2019 ; Vol. 28, No. 1. pp. 180-187.
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abstract = "Purpose: ASD surgery improves a patient’s health-related quality of life, but it has a high complication rate. The aim of this study was to create a predictive model for complications after surgical treatment for adult spinal deformity (ASD), using spinal alignment, demographic data, and surgical invasiveness. Methods: This study included 195 surgically treated ASD patients who were > 50 years old and had 2-year follow-up from multicenter database. Variables which included age, gender, BMI, BMD, frailty, fusion level, UIV and LIV, primary or revision surgery, pedicle subtraction osteotomy, spinal alignment, Schwab-SRS type, surgical time, and blood loss were recorded and analyzed at least 2 years after surgery. Decision-making trees for 2-year postoperative complications were constructed and validated by a 7:3 data split for training and testing. External validation was performed for 25 ASD patients who had surgery at a different hospital. Results: Complications developed in 48{\%} of the training samples. Almost half of the complications developed in late post-op period, and implant-related complications were the most common complication at 2 years after surgery. Univariate analyses showed that BMD, frailty, PSO, LIV, PI-LL, and EBL were risk factors for complications. Multivariate analysis showed that low BMD, PI-LL > 30°, and frailty were independent risk factors for complications. In the testing samples, our predictive model was 92{\%} accurate with an area under the receiver operating characteristic curve of 0.963 and 84{\%} accurate in the external validation. Conclusion: A successful model was developed for predicting surgical complications. Our model could inform physicians about the risk of complications in ASD patients in the 2-year postoperative period. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].",
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Yagi, M, Hosogane, N, Fujita, N, Okada, E, Tsuji, O, Nagoshi, N, Asazuma, T, Tsuji, T, Nakamura, M, Matsumoto, M & Watanabe, K 2019, 'Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity', European Spine Journal, vol. 28, no. 1, pp. 180-187. https://doi.org/10.1007/s00586-018-5816-5

Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity. / Yagi, Mitsuru; Hosogane, Naobumi; Fujita, Nobuyuki; Okada, Eijiro; Tsuji, Osahiko; Nagoshi, Narihito; Asazuma, Takashi; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

In: European Spine Journal, Vol. 28, No. 1, 25.01.2019, p. 180-187.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity

AU - Yagi, Mitsuru

AU - Hosogane, Naobumi

AU - Fujita, Nobuyuki

AU - Okada, Eijiro

AU - Tsuji, Osahiko

AU - Nagoshi, Narihito

AU - Asazuma, Takashi

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2019/1/25

Y1 - 2019/1/25

N2 - Purpose: ASD surgery improves a patient’s health-related quality of life, but it has a high complication rate. The aim of this study was to create a predictive model for complications after surgical treatment for adult spinal deformity (ASD), using spinal alignment, demographic data, and surgical invasiveness. Methods: This study included 195 surgically treated ASD patients who were > 50 years old and had 2-year follow-up from multicenter database. Variables which included age, gender, BMI, BMD, frailty, fusion level, UIV and LIV, primary or revision surgery, pedicle subtraction osteotomy, spinal alignment, Schwab-SRS type, surgical time, and blood loss were recorded and analyzed at least 2 years after surgery. Decision-making trees for 2-year postoperative complications were constructed and validated by a 7:3 data split for training and testing. External validation was performed for 25 ASD patients who had surgery at a different hospital. Results: Complications developed in 48% of the training samples. Almost half of the complications developed in late post-op period, and implant-related complications were the most common complication at 2 years after surgery. Univariate analyses showed that BMD, frailty, PSO, LIV, PI-LL, and EBL were risk factors for complications. Multivariate analysis showed that low BMD, PI-LL > 30°, and frailty were independent risk factors for complications. In the testing samples, our predictive model was 92% accurate with an area under the receiver operating characteristic curve of 0.963 and 84% accurate in the external validation. Conclusion: A successful model was developed for predicting surgical complications. Our model could inform physicians about the risk of complications in ASD patients in the 2-year postoperative period. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

AB - Purpose: ASD surgery improves a patient’s health-related quality of life, but it has a high complication rate. The aim of this study was to create a predictive model for complications after surgical treatment for adult spinal deformity (ASD), using spinal alignment, demographic data, and surgical invasiveness. Methods: This study included 195 surgically treated ASD patients who were > 50 years old and had 2-year follow-up from multicenter database. Variables which included age, gender, BMI, BMD, frailty, fusion level, UIV and LIV, primary or revision surgery, pedicle subtraction osteotomy, spinal alignment, Schwab-SRS type, surgical time, and blood loss were recorded and analyzed at least 2 years after surgery. Decision-making trees for 2-year postoperative complications were constructed and validated by a 7:3 data split for training and testing. External validation was performed for 25 ASD patients who had surgery at a different hospital. Results: Complications developed in 48% of the training samples. Almost half of the complications developed in late post-op period, and implant-related complications were the most common complication at 2 years after surgery. Univariate analyses showed that BMD, frailty, PSO, LIV, PI-LL, and EBL were risk factors for complications. Multivariate analysis showed that low BMD, PI-LL > 30°, and frailty were independent risk factors for complications. In the testing samples, our predictive model was 92% accurate with an area under the receiver operating characteristic curve of 0.963 and 84% accurate in the external validation. Conclusion: A successful model was developed for predicting surgical complications. Our model could inform physicians about the risk of complications in ASD patients in the 2-year postoperative period. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

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