The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2
Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Applic...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Sethi, Rajiv K. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Anmerkung: |
© Scoliosis Research Society 2019 |
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| Übergeordnetes Werk: |
Enthalten in: Spine deformity - Amsterdam [u.a.] : Elsevier, 2013, 7(2019), 5 vom: Sept., Seite 684-695 |
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| Übergeordnetes Werk: |
volume:7 ; year:2019 ; number:5 ; month:09 ; pages:684-695 |
| Links: |
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| DOI / URN: |
10.1016/j.jspd.2019.03.001 |
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| Katalog-ID: |
SPR038874733 |
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| 520 | |a Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. | ||
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| 700 | 1 | |a Lenke, Larry G. |4 aut | |
| 700 | 1 | |a Cerpa, Meghan |4 aut | |
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| 700 | 1 | |a Daniels, Alan H. |4 aut | |
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| 700 | 1 | |a Bess, Shay |4 aut | |
| 700 | 1 | |a Hart, Robert A. |4 aut | |
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10.1016/j.jspd.2019.03.001 doi (DE-627)SPR038874733 (SPR)j.jspd.2019.03.001-e DE-627 ger DE-627 rakwb eng Sethi, Rajiv K. verfasserin aut The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2019 Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. Lean (dpeaa)DE-He213 Adult spinal deformity surgery (dpeaa)DE-He213 Burton, Douglas C. aut Wright, Anna K. aut Lenke, Larry G. aut Cerpa, Meghan aut Kelly, Michael P. aut Daniels, Alan H. aut Ames, Christopher P. aut Klineberg, Eric O. aut Mundis, Gregory M. aut Bess, Shay aut Hart, Robert A. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 7(2019), 5 vom: Sept., Seite 684-695 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:7 year:2019 number:5 month:09 pages:684-695 https://dx.doi.org/10.1016/j.jspd.2019.03.001 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 7 2019 5 09 684-695 |
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10.1016/j.jspd.2019.03.001 doi (DE-627)SPR038874733 (SPR)j.jspd.2019.03.001-e DE-627 ger DE-627 rakwb eng Sethi, Rajiv K. verfasserin aut The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2019 Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. Lean (dpeaa)DE-He213 Adult spinal deformity surgery (dpeaa)DE-He213 Burton, Douglas C. aut Wright, Anna K. aut Lenke, Larry G. aut Cerpa, Meghan aut Kelly, Michael P. aut Daniels, Alan H. aut Ames, Christopher P. aut Klineberg, Eric O. aut Mundis, Gregory M. aut Bess, Shay aut Hart, Robert A. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 7(2019), 5 vom: Sept., Seite 684-695 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:7 year:2019 number:5 month:09 pages:684-695 https://dx.doi.org/10.1016/j.jspd.2019.03.001 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 7 2019 5 09 684-695 |
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10.1016/j.jspd.2019.03.001 doi (DE-627)SPR038874733 (SPR)j.jspd.2019.03.001-e DE-627 ger DE-627 rakwb eng Sethi, Rajiv K. verfasserin aut The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2019 Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. Lean (dpeaa)DE-He213 Adult spinal deformity surgery (dpeaa)DE-He213 Burton, Douglas C. aut Wright, Anna K. aut Lenke, Larry G. aut Cerpa, Meghan aut Kelly, Michael P. aut Daniels, Alan H. aut Ames, Christopher P. aut Klineberg, Eric O. aut Mundis, Gregory M. aut Bess, Shay aut Hart, Robert A. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 7(2019), 5 vom: Sept., Seite 684-695 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:7 year:2019 number:5 month:09 pages:684-695 https://dx.doi.org/10.1016/j.jspd.2019.03.001 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 7 2019 5 09 684-695 |
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10.1016/j.jspd.2019.03.001 doi (DE-627)SPR038874733 (SPR)j.jspd.2019.03.001-e DE-627 ger DE-627 rakwb eng Sethi, Rajiv K. verfasserin aut The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2019 Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. Lean (dpeaa)DE-He213 Adult spinal deformity surgery (dpeaa)DE-He213 Burton, Douglas C. aut Wright, Anna K. aut Lenke, Larry G. aut Cerpa, Meghan aut Kelly, Michael P. aut Daniels, Alan H. aut Ames, Christopher P. aut Klineberg, Eric O. aut Mundis, Gregory M. aut Bess, Shay aut Hart, Robert A. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 7(2019), 5 vom: Sept., Seite 684-695 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:7 year:2019 number:5 month:09 pages:684-695 https://dx.doi.org/10.1016/j.jspd.2019.03.001 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 7 2019 5 09 684-695 |
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10.1016/j.jspd.2019.03.001 doi (DE-627)SPR038874733 (SPR)j.jspd.2019.03.001-e DE-627 ger DE-627 rakwb eng Sethi, Rajiv K. verfasserin aut The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2019 Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. Lean (dpeaa)DE-He213 Adult spinal deformity surgery (dpeaa)DE-He213 Burton, Douglas C. aut Wright, Anna K. aut Lenke, Larry G. aut Cerpa, Meghan aut Kelly, Michael P. aut Daniels, Alan H. aut Ames, Christopher P. aut Klineberg, Eric O. aut Mundis, Gregory M. aut Bess, Shay aut Hart, Robert A. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 7(2019), 5 vom: Sept., Seite 684-695 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:7 year:2019 number:5 month:09 pages:684-695 https://dx.doi.org/10.1016/j.jspd.2019.03.001 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 7 2019 5 09 684-695 |
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Sethi, Rajiv K. @@aut@@ Burton, Douglas C. @@aut@@ Wright, Anna K. @@aut@@ Lenke, Larry G. @@aut@@ Cerpa, Meghan @@aut@@ Kelly, Michael P. @@aut@@ Daniels, Alan H. @@aut@@ Ames, Christopher P. @@aut@@ Klineberg, Eric O. @@aut@@ Mundis, Gregory M. @@aut@@ Bess, Shay @@aut@@ Hart, Robert A. @@aut@@ |
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Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. 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role of potentially modifiable factors in a standard work protocol to decrease complications in adult spinal deformity surgery: a systematic review, part 2 |
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The Role of Potentially Modifiable Factors in a Standard Work Protocol to Decrease Complications in Adult Spinal Deformity Surgery: A Systematic Review, Part 2 |
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Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. © Scoliosis Research Society 2019 |
| abstractGer |
Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. © Scoliosis Research Society 2019 |
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Study Design Structured literature review. Objectives To review the current literature for potentially modifiable patient and surgical factors that could be incorporated into a Standard Work protocol to decrease complications in adult spinal deformity (ASD) surgery. Summary of Background Data Application of lean methodology to health care involves standardization of work flow. Successful implementation of LEAN management can lead to dramatic reduction in variability and waste. Frailty, hemoglobin A1c (HbA1c) concentration, vitamin D level, mental health status, intraoperative fluid management (IFM), and tranexamic acid (TXA) administration may be modified to reduce complications after ASD surgery. Methods Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, Ovid, and Google Scholar databases were used to identify abstracts and citations for this review. Each topic was developed into an appropriate clinical question that included the patient population, surgical intervention, a comparison group, and outcomes measure (PICO question). From 373 initial citations with abstract, 134 articles underwent full-text review. The best available evidence for clinical questions regarding the influence of these factors was provided by 43 included studies. Results We found fair evidence supporting an association between preoperative mental health disorders, frailty, vitamin D deficiency, and higher HbA1c levels and increased complications. Conversely, we found good evidence supporting an association between the use of intraoperative TXA and an optimized intraoperative fluid management and decreased complications. Conclusion Gaps in the existing literature limit our ability to evaluate if all of the patient and surgical factors selected for this review are associated with increased or decreased complications and reoperations in ASD surgery. However, for both intraoperative TXA usage and optimized intraoperative fluid management that were supported by good evidence, developing Standard Work Protocols may optimize care. Level of Evidence Level II. © Scoliosis Research Society 2019 |
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