Comparative analysis of perioperative complications between a multicenter prospective cervical deformity database and the Nationwide Inpatient Sample database

Abstract Background Context Complication rates for adult cervical deformity are poorly characterized given the complexity and heterogeneity of cases. Purpose To compare perioperative complication rates following adult cervical deformity corrective surgery between a prospective multicenter database for patients with cervical deformity (PCD) and the Nationwide Inpatient Sample (NIS). Study Design/Setting Retrospective review of prospective databases. Patient Sample A total of 11,501 adult patients with cervical deformity (11,379 patients from the NIS and 122 patients from the PCD database). Outcome Measures Perioperative medical and surgical complications. Methods The NIS was queried (2001–2013) for cervical deformity discharges for patients ≥18 years undergoing cervical fusions using International Classification of Disease, Ninth Revision (ICD-9) coding. Patients ≥18 years from the PCD database (2013–2015) were selected. Equivalent complications were identified and rates were compared. Bonferroni correction (p Results A total of 11,379 patients from the NIS database and 122 patiens from the PCD database were identified. Patients from the PCD database were older (62.49 vs. 55.15, p .004). Based on surgicalapproach, the PCD reported higher GI and neurologic complication rates for combined anterior-posterior procedures (p Conclusions Analysis of the surgeon-maintained cervical database revealed higher overall and individual complication rates and higher data granularity. The nationwide database may underestimate complications of patients with adult cervical deformity (ACD) particularly in regard to perioperative surgical details owing to coding and deformity generalizations. The surgeon-maintained database captures the surgical details, but may underestimate some medical complications.