| Autor: |
San-Juan, Rafael, Paredes, Igor, Ramírez-Nava, Esther, Delgado-Fernández, Juan, Panero, Irene, Hernández-Ortiz, Paula, Ramírez-Vicente, Elia, Fernández-Ruiz, Mario, López-Medrano, Francisco, Corbella, Laura, Rodríguez-Goncer, Isabel, Brañas, Patricia, Lagares, Alfonso, Aguado, José María |
| Předmět: |
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| Zdroj: |
Global Spine Journal; Mar2024, Vol. 14 Issue 2, p438-446, 9p |
| Abstrakt: |
Study Design: Retrospective cohort study. Objective: Although surgical risk factors for developing spine surgical site infections (S-SSI) have been identified, the impact of such knowledge in its prevention has not been demonstrated. Methods: We evaluated in 500 patients undergoing spine surgery between 2011 and 2019 at Hospital 12 de Octubre the changes in S-SSI rates over time. Surgical variables independently related to S-SSI were analyzed by univariate and multivariate analysis using binary logistic regression models. A case-control sub-analysis (1:4), matched by the surgical variables identified in the overall cohort was also performed. Results: Twenty cases of S-SSI were identified (4%), with a significant decrease in the incidence rate across consecutive time periods (6.6% [2011-2014] vs.86% [2015-2019]; P -value <.0001)). Multivariate analysis identified arthrodesis involving sacral levels (odds ratio [OR]: 2.57; 95% confidence interval [95%CI]: 1.02-6.47; P- value =.044) and instrumentation over 4-8 vertebrae (OR: 2.82; 95%CI: 1.1-7.1; P- value =.027) as independent risk factors for S-SSI. The reduction in the incidence of S-SSI concurred temporally with a reduction in instrumentations involving 4-8 vertebrae (55% vs 21.8%; P- value <.0001) and sacral vertebrae (46.9% vs 24.6%; P -value <.0001) across both periods. The case-control analysis matched by these surgical variables failed to identify other factors independently related to the occurrence of S-SSI. Conclusions: Spinal fusion of more than 4 levels and the inclusion of sacral levels were independently related to the risk of S-SSI. Optimization of surgical techniques by reducing these two types of instrumentation could significantly reduce S-SSI rates. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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