Análise prospectiva das intercorrências clínicas em 718 pacientes submetidos a procedimentos neurocirúrgicos

We prospectively analysed 718 patients of the Neurosurgical Clinic Division of the Hospital das Clinicas da Faculdade de Medicina de Sao Paulo from february until november 1998. The objective were to identify the main posoperative clinical complications in neurosurgery, to varify relating factors and to discuss prevention. The neurosurgical procedures were classified according to four categories I-II-III-IV; I: less than two hours duration, II: between two and four hours, III: between four and six hours and IV: more than six hours. Operations for trauma, brain injury, shunts for hydrocephalus, sural biopsies, carpal and tarsal syndrome were not included. The complications were characterized before patient discharge and outpatient follow up. The main complications were: pneumonia/atelectasis (26 patients), urinary tract infection (12 patients), sodium disturbances (11 patients), deep venous trombosis and pulmonary embolism (5 patients), pleural effusion and pneumothorax (5 patients) and others less usual, like acute renal failure, bacteremia, spesis, skin allergies, Steven-Johnsons syndrome and glotis edema. The clinical complications in the neurosurgical patient can cause secondary neurological compromise and increase morbidity and mortality.