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Erschienen in: European Spine Journal 9/2019

02.07.2019 | Original Article

The impact of anesthesia and surgical provider characteristics on outcomes after spine surgery

verfasst von: Lauren A. Wilson, Megan Fiasconaro, Jashvant Poeran, Jiabin Liu, Federico Girardi, Stavros G. Memtsoudis

Erschienen in: European Spine Journal | Ausgabe 9/2019

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Abstract

Purpose

Information regarding the impact of provider characteristics on perioperative outcomes in the spine surgery setting is limited. Existing studies primarily consider the impact of surgical provider volume. This analysis sought to identify the impact of anesthesiologist and surgeon volume and experience as well as anesthesia care team composition on adverse outcomes following anterior cervical discectomy and fusions (ACDF) and posterior lumbar fusions (PLF).

Methods

We identified 5900 patients who underwent ACDF or PLF procedures at a high-volume orthopedic institution from 2005 to 2014. Provider characteristics of interest were anesthesiologist and surgeon volume and experience along with anesthesia care team composition. Multivariable logistic regression models were used to evaluate the outcomes of any complication, cardiopulmonary complication, and prolonged length of stay (> 7 days). Intraclass correlation coefficients were calculated to determine how much variation in outcomes could be explained by provider characteristics.

Results

There were no significant relationships between provider characteristics and perioperative outcomes among ACDF patients. Within the PLF cohort, surgeon annual case volume > 25 was associated with decreased odds of prolonged length of stay, while anesthesia resident involvement was associated with increased odds of prolonged length of stay. Surgeon characteristics explained the greatest proportion of variation in outcomes while anesthesiologist characteristics explained the least.

Conclusions

Anesthesia provider volume and experience did not significantly impact the odds of adverse outcome for ACDF and PLF patients. Higher surgeon volume was exclusively associated with decreased odds of prolonged length of stay following PLF. Further study is necessary to determine if these relationships persist in a less-specialized setting.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.
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Metadaten
Titel
The impact of anesthesia and surgical provider characteristics on outcomes after spine surgery
verfasst von
Lauren A. Wilson
Megan Fiasconaro
Jashvant Poeran
Jiabin Liu
Federico Girardi
Stavros G. Memtsoudis
Publikationsdatum
02.07.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 9/2019
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-019-06055-5

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