Because of database constraints, many studies only monitor outcomes after surgeries like posterior lumbar fusion (PLF) for 30 days. However, detrimental occurrences may not have reached a halt by that point. As a result, researchers employed a different database for a study to assess the timing of adverse events 90 days following PLF.

Adult PLF patients were identified using the administrative data collection M53Ortho PearlDiver Q2 from 2010 to 2020. The frequencies of various adverse events were assessed after ninety days. The timing of diagnosis for each occurrence was established in the 90-day postoperative period. The data were divided into two groups based on when they occurred: days 0 to 30 and days 31 to 90. For each adverse event, the median, interquartile range, and middle 80% were calculated at the time of diagnosis. 

Within 90 days of PLF, 7,141 (13.8%) of the 51,915 patients suffered an adverse event. Of them, 5,174 (72.5%) had an event within 30 days and 2,544 (35.6%) had an event after 30 days. The percentage of individual unfavourable events that occurred 31 to 90 days after surgery ranged from 9% to 42%. Transfusion (2 days; 2 to 5 days; 1 to 26 days), acute kidney injury (9; 2 to 29; 1 to 60), hematoma (9; 4 to 20; 3 to 39), cardiac event (11; 3 to 43; 1 to 71), pneumonia (12; 4 to 38; 2 to 68), venous thromboembolism (15; 6 to 33; 3 to 62), sepsis (19; 9 to 39; 4 to 63), surgical site infection (21; 14 to 34; 8 to 48), urinary tract infection (22; 8 to 49; 4 to 72), and wound dehiscence (27; 17 to 39; 9 to 54).

Because almost one-third of adverse events in the research were detected 31 to 90 days following surgery, the study emphasized the necessity of monitoring beyond the 30-day mark for adverse events after PLF. It can impact research investigations, patient counseling regarding the likelihood of certain adverse events, and the establishment of surveillance methods at important time periods.

Reference:journals.lww.com/jaaos/Abstract/2022/06010/Adverse_Events_After_Posterior_Lumbar_Fusion_Are.6.aspx