The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 1

摘要: Abstract Study Design Structured Literature Review. Objectives We sought to evaluate the peer-reviewed literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Lean Methodology uses improve efficiency waste error. ASD is known have high complication rate. Several been suggested affect complications, including preoperative hemoglobin, bone density, body mass index (BMI), age-appropriate realignment, albumin/prealbumin, smoking status. evidence supporting these include complications. Methods Each six was developed an appropriate clinical question included population, intervention, comparison group, outcomes measure (PICO question). A comprehensive search then performed. The authors reviewed abstracts analyzed data from studies. From 456 initial citations with abstract, 173 articles underwent full-text review. best available questions regarding influence provided by 93 Results found fair low hemoglobin level associated increased transfusion rates decreased BMD BMI rates. Fair supported albumin/prealbumin There associating exposure reoperations, but conflicting it no evaluating realignment Conclusion Preoperative index, status all are risk spine surgery population. Developing Protocol evaluation optimization should factors. Level Evidence II.