Description
- Abstract:
- Background: Functional neurosurgery intracranial implants are highly effective in the treatment of movement disorders and epilepsy but complications from intracranial stimulator implantation create consequential morbidity. While certain patient-specific factors have been studied in other surgical contexts, the role of these factors in contributing to complications after functional neurosurgery implant procedures has not been systematically assessed. Methods: The National Surgical Quality Improvement Program (NSQIP) database from 2006-2022 was used to review cases involving underwent intracranial stimulator implantation up to 30-days post-procedure. Many preoperative risk factors were reported on NSQIP and examined from 2006-2022. Wound complications were recorded as superficial, deep, and/or organ space infections as well as wound disruption; systemic complications were recorded as sepsis, septic shock, urinary tract infection (UTI), and pneumonia. After initial univariate testing, multivariate adjusted analysis correcting for age, sex, race, and American Society of Anesthesia (ASA) classification was used to determine the impact of these factors on wound/systemic complications. Results: 6930 patients between 2006-2022 underwent intracranial stimulator implantation. 56 (0.81%) had a wound complication and 49 (0.71%) had a systemic complication post-implantation. Smoking status within one-year was found to be an independent predictor of both wound (OR=4.26, 95%CI[2.32-7.82], p<0.001) and systemic complications (OR=2.73, 95%CI[1.30-5.70], p=0.008). History of COPD (OR=4.27, 95%CI[1.62-11.25], p=0.003), chronic steroid use (OR=3.79, 95%CI[1.33-10.80], p=0.013), bleeding disorders (OR=3.84, 95%CI[1.16-12.73], p=0.028), and prior sepsis (OR=9.72, 95%CI[2.22-42.63], p=0.003) were found to be independent predictors of systemic complications. No preoperative risk factor was found to be an independent predictor of wound complications alone. Conclusions: These results suggest smoking status within one-year, history of COPD, chronic steroid use, bleeding disorders, and prior sepsis to be associated with complications. Due to selection bias and a 30-day postoperative timeline, the effect of these factors may be different than assessed. Further studies are needed to better evaluate the impact of these and other risk factors.
- Notes:
- Scholarly concentration: Non-Scholarly Concentrator
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Citation
Oldam, Joseph, Porto, Carl, Taman, Mazen, et al.,
"The Influence of Patient-specific Risk Factors on Complications After Functional Neurosurgery Implant Procedures"
(2024).
Warren Alpert Medical School Academic Symposium.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:zrjb88pe/
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Warren Alpert Medical School Academic Symposium
The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …...