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Journal of Neurosurgical Sciences 2021 Mar 11

DOI: 10.23736/S0390-5616.21.05083-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Post-operative complications in cranial and spine neurosurgery: a prospective observational study

Sebastien BOISSONNEAU 1, 2 , Marc TSIAREMBY 3, Hadrien PEYRIERE 1, Thomas GRAILLON 1, 4, Kaissar FARAH 1, Stephane FUENTES 1, Henry DUFOUR 1, 4

1 Department of Neurosurgery, Aix-Marseille Université, APHM, CHU Timone, Marseille, France; 2 Inserm, INS, Institute of Neurosciences of Systems, Aix Marseille University, Marseille, France; 3 Neurosurgical Unit, CHU Joseph Ravoahangy Andrianavalona, Ampefiloha, Antananarivo, Madagascar; 4 Aix-Marseille University, INSERM, MMG, Marseille, France


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BACKGROUND: Post-operative complications do occur in all neurosurgical departments, but the way they are defined, and their true incidence vary a lot. The aim of the present study is to objectively assess the morbidity and mortality related to all neurosurgical procedures performed in our department and provide insight on their main causes and identify key factors to reduce their incidence.
METHODS: Data were retrieved from a prospectively-maintained database regarding all patients undergoing a cranial or spinal neurosurgical procedure between November 2016 and April 2016 in the neurosurgical department in Timone University Hospital (APHMMarseille). Patients undergoing a functional, pediatric or interventional neuroradiological procedures were not included.
RESULTS: The medical records of a total number of 963 patients were analyzed. A postoperative complication occurred in 208 patients (21.6%) including 115 (26.6%) in the cranial surgery group and 93 (17.5%) in the spinal surgery group. A complication occurred 1.5 more frequently in the cranial than in the spinal surgery group. Cranial surgery is 1.5 times more at risk of complications than spinal surgery (p=0.007). Preoperative comorbidities (ASA score > 3 to 4) were significantly associated with the occurrence of complications (p<.001). In the cranial group, procedures performed in an emergency setting were 1.8 times more at risk of complications than scheduled surgeries (p<.001). Conversely, in the spine group, scheduled surgeries were 1.4 times less at risk than emergency procedures (p=0.04). The main complication in both groups was found to be post-operative infection, with an incidence of 9.3% and 11.1% for cranial and spinal surgery respectively. Post-operative mortality reached 4.9% and 1.7% and the average length of stay was 12 and 11 days respectively.
CONCLUSIONS: The incidence of complication in our series was found to be relatively high with predominantly infection as the main cause of postoperative complications. Reinforcing good practice measures at every step should help to significantly decrease our complication rate.


KEY WORDS: Post-procedural complications; Cranial surgery; Spine surgery; Post-operative complications

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