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Related Experiment Video

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The implementation and efficacy of the Northwestern High Risk Spine Protocol.

Carine Zeeni1, Louanne M Carabini2, Robert W Gould3

  • 1Department of Anesthesia, American University of Beirut Medical Center, Beirut, Lebanon.

World Neurosurgery
|June 21, 2014
PubMed
Summary

The high risk spine (HRS) protocol improved patient safety in complex spine fusion surgery by reducing surgical time and blood transfusions, with minimal protocol violations. This demonstrates its efficacy and feasibility.

Keywords:
ChecklistCritical pathwaysHemostasisPatient care teamSpinal fusion

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Area of Science:

  • Neurosurgery
  • Surgical Safety
  • Patient Outcomes

Background:

  • Complex spine fusion surgery poses significant perioperative risks.
  • Existing protocols may not adequately address intraoperative safety for high-risk spine patients.

Purpose of the Study:

  • To evaluate the efficacy and implementation feasibility of an intraoperative high risk spine (HRS) protocol.
  • To enhance perioperative patient safety in complex spine fusion procedures.

Main Methods:

  • A paired availability study design was employed.
  • Efficacy was measured by red blood cell transfusion units; compliance by protocol violations.
  • Compared outcomes between traditional methods and the new HRS protocol.

Main Results:

  • The HRS protocol group experienced a 70-minute shorter surgical duration (P < 0.0001).
  • Patients on the HRS protocol received 1.1 units less red blood cells (P = 0.006).
  • Protocol violations were low at 2.6%.

Conclusions:

  • The intraoperative HRS protocol effectively maintains a safe surgical environment.
  • The protocol, utilizing communication and hemostasis checklists, was readily implemented over three years.
  • It shows promise for improving safety in high-risk spine surgery.