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
by
, , ,
Rafael De la Garza Ramos
1,2,*
,
Jessica Ryvlin
1,
Ali Haider Bangash
1
,
Mousa K. Hamad
1,2,
Mitchell S. Fourman
1,3
,
John H. Shin
4,
Yaroslav Gelfand
1,2,
Saikiran Murthy
1,2 and
Reza Yassari
1,2 1
Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
2
Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
3
Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA
4
Department of Neurological Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(15), 2741; https://doi.org/10.3390/cancers16152741
Submission received: 2 June 2024
/
Revised: 28 July 2024
/
Accepted: 30 July 2024
/
Published: 1 August 2024
(This article belongs to the Special Issue Socio-Demographic Factors and Cancer Research)
Simple Summary
This research aims to understand the influence of sociodemographic, socioeconomic, clinical, oncologic, and operative parameters on a patient’s risk of major complications or death within 30 days after surgery for spinal tumors that have spread from other parts of the body. The researchers looked at data from 165 patients who had this surgery at a major cancer center between 2012–2023. The findings suggest that a patient’s background factors do not impact their short-term surgical outcomes. Instead, factors like the patient’s overall health, spinal cord compression severity, and nutritional status seem more important. The research community may find these findings helpful in optimizing outcomes for patients undergoing complex spinal tumor surgeries.
Abstract
The rate of major complications and 30-day mortality after surgery for metastatic spinal tumors is relatively high. While most studies have focused on baseline comorbid conditions and operative parameters as risk factors, there is limited data on the influence of other parameters such as sociodemographic or socioeconomic data on outcomes. We retrospectively analyzed data from 165 patients who underwent surgery for spinal metastases between 2012–2023. The primary outcome was development of major complications (i.e., Clavien–Dindo Grade III–IV complications), and the secondary outcome was 30-day mortality (i.e., Clavien–Dindo Grade V complications). An exploratory data analysis that included sociodemographic, socioeconomic, clinical, oncologic, and operative parameters was performed. Following multivariable analysis, independent predictors of Clavien–Dindo Grade III–IV complications were Frankel Grade A–C, lower modified Bauer score, and lower Prognostic Nutritional Index. Independent predictors of Clavien–Dindo Grade V complications) were lung primary cancer, lower modified Bauer score, lower Prognostic Nutritional Index, and use of internal fixation. No sociodemographic or socioeconomic factor was associated with either outcome. Sociodemographic and socioeconomic factors did not impact short-term surgical outcomes for metastatic spinal tumor patients in this study. Optimization of modifiable factors like nutritional status may be more important in improving outcomes in this complex patient population.
