Table 3.
Study | Type of Study | Sample Size | Surgery definition | Mean age (years) | Quality of evidence | Findings (safety outcomes) | |
---|---|---|---|---|---|---|---|
Simultaneous | Staged | ||||||
Eggli et al. 1996 | Retrospective cohort | 255 | (i) Simultaneous (ii) Staged less than 6 weeks (iii) Stage 6 weeks and 6 months |
54 | 61,3 | Very low (i) Low power (ii) Selection bias |
No difference between 3 groups |
| |||||||
Alfaro- Adrián et al. 1999 | Retrospective cohort | 202 | (i) Simultaneous (ii) Staged 2 weeks and 2 months |
65 | 63,9 | Very low (i) Low power |
No difference between groups |
| |||||||
Parvizi et al. 2006 | Retrospective cohort | 196 | (i) Simultaneous (ii) Staged 25 days and 10 months |
53 | 65 | Very low (i) Low power (ii) Selection bias |
No difference between groups |
| |||||||
Bhan 2006 | Randomized clinical trial | 168 | (i) Simultaneous (ii) Staged 3 and 7 months |
46,5 | 43,8 | Moderate (i) Low power |
More bleeding in staged surgery, more transfusion for simultaneous surgery; no difference in complications |
| |||||||
Berend et al. 2007 | Retrospective cohort | 277 | (i) Simultaneous (ii) Staged 2 weeks and 2 years |
52,7 | 57,3 | Very low (i) Poor definition for staged surgery |
More complications in simultaneous surgery |
| |||||||
Hooper et al. 2009 | Register, nested cohort | 2092 | (i) Simultaneous (ii) Staged without report of interval between surgeries |
61 | 61 | Very low (i) Selection bias |
No difference between groups |
| |||||||
Aghayev et al. 2010 | Register, nested cohort | 1819 | (i) Simultaneous (ii) Staged less than 6 months (iii) Staged 6 months and 5 years |
59 | 62 | Very low (i) Poor outcome definition |
No difference between groups |
| |||||||
Saito et al. 2016 | Retrospective cohort | 89 | (i) Simultaneous (ii) Staged in the same hospitalization |
59 | 61,9 | Very low (i) Low power |
No difference between groups |
| |||||||
Johnston et al. 2011 | Retrospective cohort | 594 | (i) Simultaneous (ii) Stage without report of interval between surgeries |
61,5 | 66,5 | Very low (i) Selection bias |
More adverse events in simultaneous surgery |
| |||||||
Lindberg-Larsen et al. 2013 | Register, nested cohort | 680 | (i) Simultaneous (ii) Staged less than 6 months (iii) Staged 6 months and 18 months |
55,7 | 66,8 | Low (i) Selection bias |
No difference between groups |
| |||||||
Rasouli et al. 2014 | Retrospective cohort | 16330 | (i) Simultaneous (ii) Staged in the same hospitalization (1 to 35 days) |
58,4 | 60,3 | Moderate (i) Selection process not clear |
More complications in staged surgery during the same in-hospital stay |
| |||||||
Garland et al. 2015 | Register, nested cohort | 42238 | (i) Simultaneous (ii) Staged less than 6 months (iii) Staged 6 months and 1 year (iv) Staged more than 1 year |
<50 years = 18,3% | <50 years = 3%, 5,3%, 7,8% | Moderate (i) Selection bias |
Simultaneous surgery is safe in young and healthy patients |
| |||||||
Quadri et al. 2015 | Retrospective cohort | 48 | (i) Simultaneous (ii) Staged without report of interval between surgeries |
39 | 42 | VERY LOW (i) Low Power (ii) Selection Bias |
No difference between groups |