Chan, Chris Yin Wei and Chiu, Chee Kidd and Ch'ng, Pei Ying and Lee, Sin Ying and Chung, Weng Hong and Hasan, Mohd Shahnaz and Kwan, Mun Keong (2021) Dual attending surgeon strategy learning curve in single-staged posterior spinal fusion (PSF) surgery for 415 idiopathic scoliosis (IS) cases. The Spine Journal, 21 (7). pp. 1049-1058. ISSN 1529-9430, DOI https://doi.org/10.1016/j.spinee.2021.02.009.
Full text not available from this repository.Abstract
BACKGROUND CONTEXT: The implementation of a dual attending surgeon strategy had improved perioperative outcomes of idiopathic scoliosis (IS) patients. Nevertheless, the learning curve of a dual attending surgeon practice in single-staged posterior spinal fusion (PSF) surgery has not been established. OBJECTIVE: To evaluate the surgical learning curve of a dual attending surgeon strategy in IS patients. STUDY DESIGN: Retrospective study. PATIENT SAMPLE: 415 IS patients (Cobb angle <90 degrees) who underwent PSF using a dual attending surgeon strategy OUTCOME MEASURES: Primary outcomes included operative time, total blood loss, allogenic blood transfusion requirement, length of hospital stay and perioperative complication rate. METHODS: Regression analysis using Locally Weighted Scatterplot Smoothing (LOWESS) method was applied to create the best-fit-curve between case number versus operative time and total blood loss in identifying cut-off points for the learning curve. RESULTS: The mean Cobb angle was 60.8+10.8 degrees. Mean operative time was 134.4+32.1 minutes and mean total blood loss was 886.0+450.6 mL. The mean length of hospital stay was 3.0+1.6 days. The learning curves of a dual attending surgeon strategy in this study were established at the 115th case (operative time) and 196th case (total blood loss) respectively (p<.001). In comparison of cases before and after the cut-off points, mean operative time reduced significantly from 147.2+ 36.5 minutes to 129.5+28.9 minutes and mean total blood loss reduced significantly from 1015.1+ 506.6 mL to 770.4+357.3 mL (p<.001). No allogenic blood transfusion was required and there were 7 perioperative complications (n=7/415, 1.7%) recorded. CONCLUSION: The learning curve of a dual surgeon strategy in single-staged PSF surgery based on operative time and total blood loss were established at 115th case and 196th case respectively (p<.001). (C) 2021 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Dual attending surgeon; Idiopathic scoliosis; Learning curve; Posterior spinal fusion |
| Subjects: | R Medicine R Medicine > RJ Pediatrics |
| Divisions: | Faculty of Medicine > School of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 28 Mar 2022 08:21 |
| Last Modified: | 28 Mar 2022 08:22 |
| URI: | http://eprints.um.edu.my/id/eprint/28596 |
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