Standardized reporting of adverse events after microvascular decompression of cranial nerves; a population-based single-institution consecutive series

被引:13
作者
Bartek, Jiri, Jr. [1 ,2 ,3 ]
Gulati, Sasha [4 ,5 ]
Unsgard, Geirmund [4 ,5 ]
Weber, Clemens [4 ,6 ]
Forander, Petter [1 ,2 ]
Solheim, Ole [4 ,5 ]
Jakola, Asgeir S. [5 ,7 ,8 ]
机构
[1] Karolinska Inst, Dept Clin Neurosci, Sect Neurosurg, Stockholm, Sweden
[2] Karolinska Univ Hosp, Dept Neurosurg, Stockholm, Sweden
[3] Rigshosp, Copenhagen Univ Hosp, Dept Neurosurg, Copenhagen, Denmark
[4] Norwegian Univ Sci & Technol, Dept Neurosci, Trondheim, Norway
[5] St Olavs Hosp, Dept Neurosurg, Trondheim, Norway
[6] Stavanger Univ Hosp, Dept Neurosurg, Stavanger, Norway
[7] Sahlgrens Univ Hosp, Dept Neurosurg, Gothenburg, Sweden
[8] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden
关键词
Microvascular decompression; Complications; Landriel Ibanez classification; ENDOSCOPIC VASCULAR DECOMPRESSION; LONG-TERM EFFECTIVENESS; TRIGEMINAL NEURALGIA; HEMIFACIAL SPASM; GLOSSOPHARYNGEAL NEURALGIA; FOLLOW-UP; COMPLICATIONS; SURGERY; SAFETY; CLASSIFICATION;
D O I
10.1007/s00701-016-2856-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
To investigate frequencies of adverse events occurring within 30 days after microvascular decompression (MVD) surgery using a standardized report form of adverse events. We conducted a retrospective review of 98 adult patients (aeyen16 years) treated with MVD between 1 January 1994 and 1 June 2013. Adverse events occurring within 30 days were classified according to the Landriel Ibanez classification for neurosurgical complications: grade I represents any non-life threatening complication treated without invasive procedures; grade II is complications requiring invasive management; grade III is life-threatening adverse events requiring treatment in an intensive care unit (ICU); grade IV is death as a result of complications. We sought to compare our results with reports from the literature. Patients' median age was 61 years (range 26-83), and 64 (65 %) were females. Indications for MVD were trigeminal neuralgia (n = 77, 79 %), glossopharyngeal neuralgia (n = 4, 4 %), hemifacial spasm (n = 16, 16 %) and combined trigeminal neuralgia and hemifacial spasm (n = 1, 1 %). The overall 30-day complication rate was 20 %, with 14 % grade I complications, 5 % grade II complications and 1 % grade III complications. The comparison with the literature was hampered by the diverse and unsystematic way of reporting complications. We provide a standardized report of postoperative complications in a consecutive patient series undergoing MVD. Due to the heterogeneous and non-standardized reporting of complications in the literature, it is difficult to know if our 20 % complication rate is low or high. Standardized reporting is a necessity for meaningful and more valid comparisons across studies. The safety of MVD, a fairly standardized neurosurgical procedure, is well suited for comparisons across centers provided that complications are reported in a standardized manner.
引用
收藏
页码:1775 / 1781
页数:7
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