A new study published in The Spine Journal compares cervical deformity perioperative complications in the Nationwide Inpatient Sample database to those reported in a multicenter prospective cervical deformity database.
He study authors examined NIS data from 2001 to 2013 for cervical deformity patients. There were 11,379 patients in the NIS and 122 patients from the multicenter database included in the study. The researchers found the patients in the multicenter database were older on average but similar in other demographics to the NIS patients.
Here are five key findings:
1. The complication rate was higher — 39.3 percent — in the multicenter database, compared with the NIS database — 9.2 percent. The multicenter database patients had an increased risk of reporting overall complications.
2. Device-related complications were more common in the NIS group, at 7.1 percent, when compared with the multicenter database, at 1.1 percent; all other complications were greater in the multicenter database group.
3. The complication rate for individual complications were:
• Peripheral vascular: 0.8 percent in the multicenter database, 0.1 percent in NIS
• Infection: 8.2 percent in the multicenter database, 0.5 percent in NIS
• Dural tear: 4.1 percent in the multicenter database, 0.6 percent in NIS
• Dysphagia: 9.8 percent in the multicenter database, 1.9 percent in NIS
4. Four complications — genitourinary, wound and deep vein thrombosis — were similar in both groups, according to the study abstract.
5. In patients with combined anterior/posterior procedures, the multicenter database reported higher GI and neurologic complication rates. Among patients with posterior-only procedures, the NIS had more device-related complications while the multicenter database patients reported a higher rate of infections.
"The national database may underestimate ACD patient complications particularly in regard to perioperative surgical details due to coding and deformity generalizations," concluded the study authors. "The surgeon-maintained database captures the surgical details, but may underestimate some medical complications."