Quality metrics in adult spinal deformity surgery over the last decade: a combined analysis of the largest prospective multicenter data sets

作者：Ferrán Pellisé, Miquel Serra‐Burriel, Alba Vila-Casademunt, Jeffrey L. Gum, Ibrahim Obeid, Justin S. Smith, Frank Kleinstück, Shay Bess, Javier Pizones, Virginie Lafage, Francisco Javier Sánchez Pérez-Grueso, Frank J. Schwab, Douglas C. Burton, Eric O. Klineberg, Christopher I. Shaffrey, Ahmet Alanay, Christopher P. Ames, _ _ · 发表于：Journal of Neurosurgery Spine · 年份：2021 · DOI：10.3171/2021.3.spine202140 · 被引用次数：25 · 研究领域：Scoliosis diagnosis and treatment、Spine and Intervertebral Disc Pathology、Cervical and Thoracic Myelopathy

OBJECTIVE: The reported rate of complications and cost of adult spinal deformity (ASD) surgery, associated with an exponential increase in the number of surgeries, cause alarm among healthcare payers and providers worldwide. The authors conjointly analyzed the largest prospective available ASD data sets to define trends in quality-of-care indicators (complications, reinterventions, and health-related quality of life [HRQOL] outcomes) since 2010. METHODS: This is an observational prospective longitudinal cohort study. Patients underwent surgery between January 2010 and December 2016, with > 2 years of follow-up data. Demographic, surgical, radiological, and HRQOL (i.e., Oswestry Disability Index, SF-36, Scoliosis Research Society-22r) data obtained preoperatively and at 3, 6, 12, and 24 months after surgery were evaluated. Trends and changes in indicators were analyzed using local regression (i.e., locally estimated scatterplot smoothing [LOESS]) and adjusted odds ratio (OR). RESULTS: Of the 2286 patients included in the 2 registries, 1520 underwent surgery between 2010 and 2016. A total of 1151 (75.7%) patients who were treated surgically at 23 centers in 5 countries met inclusion criteria. Patient recruitment increased progressively (2010-2011 vs 2015-2016: OR 1.64, p < 0.01), whereas baseline clinical characteristics (age, American Society of Anesthesiologists class, HRQOL scores, sagittal deformity) did not change. Since 2010 there has been a sustained reduction in major a...