World Neurosurg
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Missing data is a typical problem in clinical studies, where the value of variables of interest is not measured or collected for some patients. This article aimed to review imputation approaches for missing values and their application in neurosurgery. ⋯ Missing values should be treated carefully. Advantages and disadvantages of multiple imputation methods along with imputation in small and big data should be considered depending on the research question and specifics of the study.
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With the advent of personalized and stratified medicine, there has been much discussion about predictive modeling and the role of classical regression in modern medical research. We describe and distinguish the goals in these 2 frameworks for analysis. ⋯ Both classical regression and predictive modeling have important roles in modern medical research. Understanding the distinction between the 2 frameworks for analysis is important to place them in their appropriate context and interpreting findings from published studies appropriately.
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Traumatic brain injury (TBI) is a risk factor for venous thromboembolism (VTE). The risk of VTE after decompressive craniectomy (DC) and its effects on the outcomes are unknown. We assessed the incidence of VTE, associated risk factors, and effects on the outcomes. ⋯ Our study showed an independent association between DC and an increased risk of VTE for patients with severe TBI. The development of VTE after DC increased the proportion of poor outcomes, prolonged the length of stay, and increased the hospitalization costs. Older patients with obesity, an electrolyte imbalance, chronic lung disease, spine injury, and infections were at a greater risk of VTE after DC. These risk factors could help in considering VTE prophylaxis for these patients.
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To determine the association of preoperative hyponatremia with short-term postoperative complications and health care utilization (length of stay, readmissions) after anterior cervical fusion and discectomy (ACDF). ⋯ Preoperative hyponatremia is an independent risk factor for pneumonia and prolonged length of stay after ACDF.
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Adjacent segmental degeneration (ASD) is the long-term complication of transforaminal lumbar interbody fusion (TLIF) combined with pedicle screw fixation. Both osteoporosis and whole-body vibration (WBV) can alter the biomechanics of adjacent segments. However, the effect of pedicle screw fixation on ASD in an osteoporotic spine after TLIF under WBV was unknown. ⋯ In an osteoporotic spine after TLIF, removal of pedicle screw fixation can mitigate ASD in the upper adjacent segment but has no apparent influence on the lower adjacent segment under WBV.