Lower RASDS complications for higher hospital, surgeon volume

(HealthDay)—Perioperative complication rates are lower with increased hospital and surgeon volume for revision adult spinal deformity surgery (RASDS), according to research published in the Sept. 1 issue of The Spine Journal.

Justin C. Paul, M.D., from the NYU Hospital for Joint Diseases in New York City, and colleagues conducted a retrospective analysis to examine complication rates in RASDS by surgeon and hospital operative volume. Patients older than 21 years with spine arthrodesis for scoliosis were included.

Of the 139,150 adult spinal deformity surgery cases, the researchers identified 4,888 revisions with hospital identifiers and 1,978 with surgeon identifiers. More revision cases and cases requiring osteotomy were performed by higher-volume surgeons. The complication rate for RASDS decreased with increasing hospital volume (9.7 versus 12.9 percent at highest versus lowest-volume centers; P < 0.001). Significant decreases in the rate of major complications for RASDS were seen for the highest- versus lowest-volume surgeons (8.8 versus 10.7 percent; P < 0.001). Compared with the lowest-volume hospitals, reduced odds ratios were seen for the highest-volume hospitals and surgeons for all complications.

"Future inter-hospital and inter-surgeon comparisons should account for these case characteristics so that similar case complexity is compared in these analyses," the authors write.

Several authors disclosed financial ties to the medical device industry.

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