Adverse Events After Microvascular Decompression: A National Surgical Quality Improvement Program Analysis

Area of Science:

• Neurosurgery
• Surgical Outcomes
• Patient Safety

Background:

• Microvascular decompression (MVD) is a definitive treatment for specific neuralgia conditions.
• Predictors of postoperative complications following MVD are not well-established in national studies.

Purpose of the Study:

• To identify the incidence of adverse events after MVD.
• To determine risk factors associated with postoperative complications and readmission following MVD.

Main Methods:

• Analysis of prospectively collected data from the National Surgical Quality Improvement Program (NSQIP) registry (2006-2017).
• Inclusion of 1005 patients who underwent MVD.
• Utilization of multivariable logistic and linear regression models to identify predictors of adverse events, readmission, and hospital stay duration.

Main Results:

• Low rates of mortality (0.3%) and major neurologic complications (0.4%) were observed.
• American Society of Anesthesiologists (ASA) classification III-IV and longer operative duration predicted adverse events and longer hospital stays.
• The 30-day readmission rate was 6.8%, with surgical site infections and cerebrospinal fluid leakage as primary causes. Higher ASA classification, diabetes mellitus, and operative time predicted readmission.

Conclusions:

• Postoperative morbidity and mortality following MVD are low.
• Higher ASA classification, diabetes mellitus, and longer operative duration are significant predictors of adverse events and readmission.
• ASA classification offers superior risk stratification compared to other patient factors for MVD procedures.