BACKGROUND Neurosurgical procedures are life- and function-saving but carry a risk of adverse events (AE) which can cause permanent neurologic deficits. Unfortunately, there is lack of clearly defined AEs associated with given procedures, and their reporting is non-uniform and often arbitrary. However, with an increasing number of neurosurgical procedures performed, there is a need for standardization of AEs for systematic tracking. Such a system would establish a baseline for future quality improvement strategies. OBJECTIVE To review our institutional AEs and devise standardized titles specific to the spine, tumor, functional, and vascular neurosurgery divisions. METHODS A review of prospective monthly-reported morbidity and mortality (M&M) conference data within the Department of Neurological Surgery was conducted from January 2017 to December 2019. An AE was defined as any mortality, an "unintended and undesirable diagnostic or therapeutic event", "an event that prolongs the patient's hospital stay", or an outcome with permanent or transient neurologic deficit. RESULTS A total of 1096 AEs from 7418 total procedures (14.8 %) were identified. Of those, 418 (5.6 %) were in cerebrovascular, 249 (3.4 %) were in neuro-oncology and 429 (5.8 %) were in the spine & functional divisions. The most common AEs across all divisions were infection (17 %), hemorrhage (11 %) and cerebrospinal fluid (CSF) leak (7.8 %). Other AEs were indirectly related to the neurosurgical procedure, such as deep vein thrombosis or pulmonary embolism (2.7 %), or pneumothorax (0.3 %). CONCLUSION This work illustrates standardized AEs can be implemented universally across the spectrum of neurological surgery. Standardization can help identify recurring AE patterns through better tracking.

中文翻译：

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制定标准化标题以对 7,418 次颅脑和脊髓神经外科手术中的不良事件进行分类

背景神经外科手术可以挽救生命和功能，但存在可能导致永久性神经功能缺损的不良事件（AE）风险。不幸的是，缺乏与给定程序相关的明确定义的 AE，并且它们的报告不统一且通常是任意的。然而，随着神经外科手术数量的增加，需要对 AE 进行标准化以进行系统跟踪。这样的系统将为未来的质量改进战略建立基线。目标审查我们的机构 AE 并设计特定于脊柱、肿瘤、功能和血管神经外科部门的标准化标题。方法 对前瞻性每月报告的发病率和死亡率 (M& M) 神经外科会议数据于 2017 年 1 月至 2019 年 12 月进行。 AE 定义为任何死亡、“非预期和不希望的诊断或治疗事件”、“延长患者住院时间的事件”，或永久性或暂时性神经功能缺损的结果。结果 总共确定了 7418 个程序 (14.8%) 中的 1096 个 AE。其中，418 人（5.6 %）在脑血管科，249 人（3.4 %）在神经肿瘤科，429 人（5.8 %）在脊柱和功能部门。所有部门最常见的 AE 是感染 (17%)、出血 (11%) 和脑脊液 (CSF) 渗漏 (7.8%)。其他 AE 与神经外科手术间接相关，例如深静脉血栓形成或肺栓塞 (2.7%) 或气胸 (0.3%)。结论 这项工作说明标准化 AE 可以在神经外科手术范围内普遍实施。标准化可以通过更好的跟踪帮助识别重复出现的 AE 模式。