Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures
Study Design A retrospective cohort study of patients with surgically treated thoracolumbar fractures. Purpose This study aimed to describe the incidence of adverse events (AEs) after surgical stabilization of thoracolumbar spine injuries and to identify predictive factors for the occurrence of AEs....
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-12-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2021-0231.pdf |
| _version_ | 1797961391317975040 |
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| author | Gabriel Liu Jiong Hao Tan Jun Cheong Kong Yong Hao Joel Tan Nishant Kumar Shen Liang Seah Jing Sheng Shawn Chiu Shi Ting Lau Leok Lim Hey Hwee Weng Dennis Naresh Kumar Joseph Thambiah Hee-Kit Wong |
| author_facet | Gabriel Liu Jiong Hao Tan Jun Cheong Kong Yong Hao Joel Tan Nishant Kumar Shen Liang Seah Jing Sheng Shawn Chiu Shi Ting Lau Leok Lim Hey Hwee Weng Dennis Naresh Kumar Joseph Thambiah Hee-Kit Wong |
| author_sort | Gabriel Liu |
| collection | DOAJ |
| description | Study Design A retrospective cohort study of patients with surgically treated thoracolumbar fractures. Purpose This study aimed to describe the incidence of adverse events (AEs) after surgical stabilization of thoracolumbar spine injuries and to identify predictive factors for the occurrence of AEs. Overview of Literature Thoracolumbar spine fractures are frequently present in patients with blunt trauma and are associated with significant morbidity. AEs can occur due to the initial spinal injury or secondary to surgical treatment. There is a lack of emphasis in the literature on the AEs that can occur after operative management of thoracolumbar fractures. Methods We performed a retrospective review of 199 patients with surgically treated thoracolumbar fractures operated between January 2007 and January 2018. The potential risk factors for the development of AEs as well as the development of common complications were evaluated by univariate analysis, and a multivariate logistic regression analysis was performed to identify independent risk factors predictive of the above. Results The overall rate of AEs was 46.7%; 83 patients (41.7%) had nonsurgical AEs, whereas 24 (12.1%) had surgical adverse events. The most common AEs were urinary tract infections in 43 patients (21.6%), and hospital-acquired pneumonia in 21 patients (10.6%). On multivariate logistic regression, a Thoracolumbar Injury Classification and Severity (TLICS) score of 8–10 (odds ratio [OR], 6.39; 95% confidence interval [CI], 2.33–17.51), the presence of polytrauma (OR, 2.64; 95% CI, 1.17–5.99), and undergoing open surgery (OR, 2.31; 95% CI, 1.09–4.88) were significant risk factors for AEs. The absence of neurological deficit was associated with a lower rate of AEs (OR, 0.47; 95% CI, 0.31–0.70). Conclusions This study suggests the presence of polytrauma, preoperative American Spinal Injury Association score, and TLICS score are predictive of AEs in patients with surgically treated thoracolumbar fractures. The results might also suggest a role for minimally invasive surgical methods in reducing AEs in these patients. |
| first_indexed | 2024-04-11T00:57:41Z |
| format | Article |
| id | doaj.art-72db53cae6124dc68e4e9afdafd3c4b5 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-11T00:57:41Z |
| publishDate | 2022-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-72db53cae6124dc68e4e9afdafd3c4b52023-01-04T23:59:28ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-12-0116684885610.31616/asj.2021.02311485Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar FracturesGabriel Liu0Jiong Hao Tan1Jun Cheong Kong2Yong Hao Joel Tan3Nishant Kumar4Shen Liang5Seah Jing Sheng Shawn6Chiu Shi Ting7Lau Leok Lim8Hey Hwee Weng Dennis9Naresh Kumar10Joseph Thambiah11Hee-Kit Wong12 University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore Yong Loo Lin School of Medicine, National University of Singapore, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, Singapore University Spine Centre, Department of Orthopaedic Surgery, National University Hospital, SingaporeStudy Design A retrospective cohort study of patients with surgically treated thoracolumbar fractures. Purpose This study aimed to describe the incidence of adverse events (AEs) after surgical stabilization of thoracolumbar spine injuries and to identify predictive factors for the occurrence of AEs. Overview of Literature Thoracolumbar spine fractures are frequently present in patients with blunt trauma and are associated with significant morbidity. AEs can occur due to the initial spinal injury or secondary to surgical treatment. There is a lack of emphasis in the literature on the AEs that can occur after operative management of thoracolumbar fractures. Methods We performed a retrospective review of 199 patients with surgically treated thoracolumbar fractures operated between January 2007 and January 2018. The potential risk factors for the development of AEs as well as the development of common complications were evaluated by univariate analysis, and a multivariate logistic regression analysis was performed to identify independent risk factors predictive of the above. Results The overall rate of AEs was 46.7%; 83 patients (41.7%) had nonsurgical AEs, whereas 24 (12.1%) had surgical adverse events. The most common AEs were urinary tract infections in 43 patients (21.6%), and hospital-acquired pneumonia in 21 patients (10.6%). On multivariate logistic regression, a Thoracolumbar Injury Classification and Severity (TLICS) score of 8–10 (odds ratio [OR], 6.39; 95% confidence interval [CI], 2.33–17.51), the presence of polytrauma (OR, 2.64; 95% CI, 1.17–5.99), and undergoing open surgery (OR, 2.31; 95% CI, 1.09–4.88) were significant risk factors for AEs. The absence of neurological deficit was associated with a lower rate of AEs (OR, 0.47; 95% CI, 0.31–0.70). Conclusions This study suggests the presence of polytrauma, preoperative American Spinal Injury Association score, and TLICS score are predictive of AEs in patients with surgically treated thoracolumbar fractures. The results might also suggest a role for minimally invasive surgical methods in reducing AEs in these patients.http://www.asianspinejournal.org/upload/pdf/asj-2021-0231.pdfspinal fracturespostoperative complicationsintraoperative complicationsfracture fixation |
| spellingShingle | Gabriel Liu Jiong Hao Tan Jun Cheong Kong Yong Hao Joel Tan Nishant Kumar Shen Liang Seah Jing Sheng Shawn Chiu Shi Ting Lau Leok Lim Hey Hwee Weng Dennis Naresh Kumar Joseph Thambiah Hee-Kit Wong Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures Asian Spine Journal spinal fractures postoperative complications intraoperative complications fracture fixation |
| title | Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures |
| title_full | Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures |
| title_fullStr | Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures |
| title_full_unstemmed | Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures |
| title_short | Thoracolumbar Injury Classification and Severity Score Is Predictive of Perioperative Adverse Events in Operatively Treated Thoracic and Lumbar Fractures |
| title_sort | thoracolumbar injury classification and severity score is predictive of perioperative adverse events in operatively treated thoracic and lumbar fractures |
| topic | spinal fractures postoperative complications intraoperative complications fracture fixation |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2021-0231.pdf |
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