Incidence and predictors of 30-day postoperative complications following musculoskeletal tumor surgery

Abstract

Objectives: Surgical intervention remains one of the best curative approaches in musculoskeletal (MSK) tumors. However, postoperative complications remain an issue, especially within the first 30-day postoperatively. Hence, the main objective of this study is to estimate the incidence and to identify the predictive factors of 30-day complications following MSK tumor surgery (MTS). Methods: This is a retrospective, descriptive study of 85 patients who had undergone MTS between 2016 and 2019 in our institution. The included patients were those who had MTS caused by a malignant tumor or giant cell tumor. Results: Twenty-eight patients (33%) had a complication during the first 30 days following surgery. The most common complication was surgical site infection in 64% (n = 18 / 28) followed by venous thromboembolism in 11% (n = 3 / 28) and then death in 7% of the patients (n = 2 / 28). Complications were distributed equally among genders. The complication rate was 36% in bone tumor surgeries (n = 22 / 61) and 21% in soft tissue tumor surgeries (n = 4 / 24). Ewing's sarcoma patients had the highest complication rate among bone tumors (36%, n = 8 / 22). Lower extremities' surgeries had the highest complication rate (35%, n = 18 / 51). Furthermore, 80% of the patients with a cardiovascular condition other than hypertension developed a complication (n = 4 / 5, P = 0.0322). Conclusion: One-third of the patients who underwent MTS developed a complication within a 30-day duration. The diagnosis of Ewing's sarcoma, surgery of lower extremities, and preexisting cardiovascular conditions was linked to a higher complication rate.