Surgeon's Specialty Has Limited Effect on Spinal Surgery Outcome
(HealthDay News) — Surgical specialty has limited influence on short-term outcomes after elective spine surgery, with differences noted for transfusions and length of stay, according to a study published online September 1 in Spine.
Andreea Seicean, PhD, MPH, from Case Western Reserve University in Cleveland, and colleagues used the American College of Surgeons National Surgical Quality Improvement Project database (2006–2012) to match 17,126 patients who underwent spinal fusion and laminectomy performed by an orthopedic surgeon to 17,126 patients who underwent the same procedure performed by a neurosurgeon. Matching eliminated differences in preoperative and intraoperative risk factors between surgical specialties.
The researchers found that diagnosis and procedure were the only factors that differed significantly between surgical subspecialties. Patients who underwent orthopedic surgery were more than twice as likely to experience prolonged length of stay (odds ratio, 2.6) and were significantly more likely to receive a transfusion perioperatively, have complications, and require discharge with continued care compared with patients undergoing neurosurgery. Slightly higher odds for prolonged length of stay and two-fold higher odds for receiving perioperative transfusion remained in patients undergoing orthopedic surgery even after matching. The difference in length of stay between patients who underwent orthopedic surgery and those who underwent neurosurgery was not fully explained by perioperative transfusion.
"Analysis of a large, multi-institutional sample of prospectively collected clinical data suggests that surgeon specialty has limited influence on short-term outcomes after elective spine surgery," conclude the authors.