Table 6.
Summary Table of Safety Outcomes Between Early (≤24 Hours) and Late (>24 Hours) Decompression.
| Author, Year | Measure | Early, ≤24 Hours | Late, >24 Hours | Effect Size |
|---|---|---|---|---|
| Cervical SCI | ||||
| Fehlings, 2012 | Inpatient postoperative complications, n (%) | na = 182 | na = 131 | Unadjusted RR (95% CI) |
| Prospective cohort study | Cardiopulmonary | 32 (17.6) | 34 (26.0) | 0.68 (0.44 to 1.04) |
| Construct failure requiring surgery | 3 (1.6) | 1 (0.8) | 2.16 (0.23 to 20.53) | |
| Deep wound infection | 0 (0) | 2 (1.5) | Incalculable | |
| Neurologic deterioration | 4 (2.2) | 1 (0.8) | 2.88 (0.33 to 25.46) | |
| Pulmonary embolism | 2 (1.1) | 2 (1.5) | 0.72 (0.10 to 5.04) | |
| Systemic infection | 6 (3.3) | 8 (6.1) | 0.54 (0.19 to 1.52) | |
| Wound dehiscence | 1 (0.5) | 1 (0.8) | 0.72 (0.05 to 11.40) | |
| Mortality; ≤30 days postinjury | 1 (0.5) | 1 (0.8) | 0.72 (0.05 to 11.40) | |
| Mortality; >30 days postinjury | 3 (1.6) | 0 (0) | Incalculable | |
| Cervical and thoracolumbar SCI | ||||
| Bourassa-Moreau, 2013 | Acute stay postoperative complications, n (%) | n = 90 | n = 341 | Unadjusted RR (95% CI)b |
| Retrospective cohort study | Pneumonia | 15 (16.7) | 91 (26.7) | 0.62 (0.38 to 1.02) |
| Pressure ulcer | 12 (13.3) | 73 (21.4) | 0.66 (0.37 to 1.15) | |
| Urinary tract infection | 18 (20.0) | 83 (24.3) | 0.82 (0.52 to 1.29) | |
| Other complications | 11 (12.2) | 55 (16.1) | 0.76 (0.41 to 1.39) | |
| Mortality | 3 (3.3) | 9 (2.6) | 1.26 (0.35 to 4.57) | |
| Thoracolumbar SCI | ||||
| Rahimi-Movghar, 2014 | Postoperative complications, n (%) | n = 16 | n = 19 | Unadjusted RR (95% CI) |
| RCT | Deep vein thrombosis | 1 (6.2) | 1 (5.2) | 1.2 (0.08 to 17.5) |
| Wound infection | NR | 1 (5.2) | Incalculable | |
| CSF leak | NR | 1 (5.2) | Incalculable | |
| Meningitis | NR | 1 (5.2) | Incalculable | |
| Decubitis ulcer | NR | 1 (5.2) | Incalculable | |
| Revision of surgical screws | 2 (12.5) | 3 (15.7) | 0.79 (0.15 to 4.16) | |
| Bilateral rod fracture | NR | 1 (5.2) | Incalculable | |
| Death | 1 (6.2) | 1 (5.2) | 1.2 (0.08 to 17.5) | |
Abbreviations: CSF, cerebrospinal fluid; NR, not reported; RCT, randomized controlled trial; RR, risk ratio; SCI, spinal cord injury.
aDenominator is total number of subjects enrolled because information on timing of complications and number of patients is not provided.
bRRs were calculated by combining 24-72 hour and >72 hour surgery groups into a single late surgery group of >24 hours.