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Predictors of Clavien-Dindo Grade III-IV or Grade V Complications after Metastatic Spinal Tumor Surgery: An Analysis of Sociodemographic, Socioeconomic, Clinical, Oncologic, and Operative Parameters

  • 0Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
Cancers +

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August 10, 2024

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August 10, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Sociodemographic and socioeconomic factors do not impact short-term outcomes for spinal metastasis surgery patients. Modifiable factors like nutritional status are key to improving surgical outcomes in this population.

Area Of Science

  • Oncology
  • Neurosurgery
  • Surgical Outcomes Research

Background

  • Surgery for spinal metastases has high complication and mortality rates.
  • Previous research focused on clinical and operative factors, neglecting sociodemographic and socioeconomic influences.
  • Limited data exists on non-clinical predictors of surgical outcomes in this patient group.

Purpose Of The Study

  • To investigate the impact of sociodemographic and socioeconomic factors on major complications and 30-day mortality after surgery for spinal metastases.
  • To identify independent predictors of short-term surgical outcomes in patients undergoing surgery for spinal tumors.

Main Methods

  • Retrospective analysis of 165 patients undergoing surgery for spinal metastases (2012-2023).
  • Primary outcome: major complications (Clavien-Dindo Grade III-IV).
  • Secondary outcome: 30-day mortality (Clavien-Dindo Grade V).
  • Exploratory analysis of sociodemographic, socioeconomic, clinical, oncologic, and operative parameters.
  • Multivariable analysis to identify independent predictors.

Main Results

  • Independent predictors for major complications (Grade III-IV) included poor neurological grade (Frankel A-C), lower modified Bauer score, and lower Prognostic Nutritional Index.
  • Independent predictors for 30-day mortality (Grade V) included lung primary cancer, lower modified Bauer score, lower Prognostic Nutritional Index, and use of internal fixation.
  • No sociodemographic or socioeconomic factors were associated with either major complications or 30-day mortality.

Conclusions

  • Sociodemographic and socioeconomic factors do not significantly influence short-term surgical outcomes for patients with metastatic spinal tumors.
  • Optimizing modifiable factors, particularly nutritional status (Prognostic Nutritional Index), is crucial for improving outcomes in this complex patient population.
  • Further research should focus on clinical and nutritional optimization strategies.

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