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Perioperative Vision Loss Following Prone Spine Surgery: A Case-Control Study.
Azucena Becerra1, Michael Liu1, Molly Ronan1
1Kaiser Permanente School of Anesthesia, Doctor of Nursing Practice Graduate, California State University, Fullerton, Department of Nursing, Fullerton, CA.
Summary
Perioperative vision loss (POVL) after prone spine surgery is linked to longer operative times and blood transfusions. These findings highlight key surgical risks for POVL, emphasizing the need for further investigation.
Area of Science:
- Neurosurgery
- Ophthalmology
- Health Services Research
Background:
- Perioperative vision loss (POVL) is a rare but severe complication following prone spine surgery.
- Limited research exists on patient and surgical risk factors contributing to POVL.
- The National Surgical Quality Improvement Program (NSQIP) database offers a valuable resource for studying rare complications.
Purpose of the Study:
- To investigate patient and surgical risk factors associated with POVL in patients undergoing prone spine surgery.
- To utilize the NSQIP database for a comprehensive analysis of POVL risk factors.
Main Methods:
- A case-control secondary data analysis was conducted using the NSQIP database (2010-2020).
- Five POVL cases were matched with 50 randomly selected controls (n=250) based on surgery type and year.
- Univariate and multivariate conditional logistic regression analyses were performed to identify risk factors.
Main Results:
- Patients who developed POVL were significantly more likely to have received a blood transfusion within 72 hours of surgery (P < .0001).
- Prolonged operative times were also a significant risk factor for POVL (OR=1.01, 95% CI [1.003, 1.017], P=.003).
Conclusions:
- Perioperative blood transfusion and prolonged operative time are significant surgical risk factors for POVL.
- Findings align with previous research implicating blood loss and extended surgery duration.
- Further research using the NSQIP database is recommended to enhance understanding of POVL.
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