Abstract
Introduction
Spinal orthopedic surgery is a risky method for the treatment of spinal deformity. Over the past years, despite of the remarkable progress in the field of spinal surgery, the major complications from spinal surgery still occur. The aim of this study was to establish a predictive model (The Chaoyang risk score) for major complications after surgery to treat spine deformity disease and evaluate its effect for clinical application.
Methods
Data were collected retrospectively from 245 consecutive patients who underwent surgery for spine deformity disease. We defined the major postoperative complications as the occurrence of infection, nerve injury, organ dysfunction, or death after surgery. The logistic coefficient, and the additive score by odds ratio was used to calculate logistic score. The Chaoyang risk score were applied to predict Postoperative Complications. A C statistic (receiver operating characteristic curve) was used to test discrimination of the model. Calibration was assessed by Hosmer-Lemeshow goodness-of-fit statistic.
Results
The result of logistic regression showed that preoperative nerve injury, medical history of spine deformity( > 10years), time of surgery(>5 hours), Maximal voluntary ventilation observed/predicted < 50%, intraoperative osteotomy were independent factors for the complications. The simple logistic model of the Postoperative Complications risk score showed very good discriminatory ability (C statistic = 0.866 > 0.75) and calibration (Hosmer-Lemeshow, p = 0.978 > 0.05) in predicting Postoperative Complications.
Conclusion
The logistic algorithm of the Postoperative Complications risk score is a simple, objective, convenient and accurate scoring system which may be used to predict Complications after surgery to treat scoliosis disease.