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· DOS Abstracts
Morbidity and mortality of complex spine surgery:
a prospective cohort study in 679 patients
validating the SAVES system in a European
population
Sven Karstensen, Tanvir Bari, Martin Gehrchen, John Street, Benny Dahl
SpineUnit, Department of Orthopaedic Surgery, Rigshospitalet and University
of Copenhagen ; ICORD, University of British Columbia
Background:
The Spine AdVerse Events Severity system (SAVES) has been
found reliable and valid in two North American spine centers, providing precise
information regarding all adverse events after complex spine surgery.
Purpose / Aim of Study:
The purpose of the present study was to assess the
generalizability of the SAVES system in a European population of patients, in-
cluding pediatric patients, undergoing complex spine surgery.
Materials and Methods:
All patients undergoing spinal surgery in the period
January 1, 2013 through December 31, 2013 were prospectively included. A
modified SAVES form was used, and a research coordinator collected all data
prospectively. Once a week all patients were reviewed for additional events,
validation of the data and clarification of any questions. The survival status was
registered on January 31, 2014 to obtain 30-day survival.
Findings / Results:
A total of 679 consecutive patients were included with
100% SAVES data completed. The in-hospital mortality was 1.3% and the 30-
day mortality was 2.7 %; all occurring after emergency procedures. There was
no significant difference between lengths of stay after elective or emergency
surgery. The number of intraoperative AE’s was 162 and the number of postop-
erative AE’s was 1415; the most frequent event being postoperative electrolyte
imbalance. 2.2% of the patients had postoperative infections requiring surgical
revision. The frequency of postoperative AE’s was significantly higher in patients
65 years or older compared to young individuals (P=0.002).
Conclusions:
The results confirm that a rigorous prospective system improves
adverse event recognition, confirming the generalizability of the SAVES system
to a non-Canadian populations including pediatric patients.
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