Intraoperative blood loss as indicated by haemoglobin trend is a predictor for the development of postoperative spinal implant infection—a matched-pair analysis
| Autor: | Schömig, Friederike, Bürger, Justus, Hu, Zhouyang, Pruß, Axel, Klotz, Edda, Pumberger, Matthias, Hipfl, Christian |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Reoperation Prosthesis-Related Infections Matched-Pair Analysis Operative Time Orthopaedic surgery Blood Loss Surgical Diseases of the musculoskeletal system Hemoglobins Intraoperative Period Predictive Value of Tests Risk Factors Sepsis Diagnosis Humans Blood Transfusion Aged Retrospective Studies Orthopedic surgery Anemia Length of Stay Middle Aged Spine Hematocrit RC925-935 Female Infection 600 Technik Medizin angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit RD701-811 Research Article |
| Zdroj: | Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-6 (2021) Journal of Orthopaedic Surgery and Research |
| Popis: | Background With a reported rate of 0.7–20%, postoperative spinal implant infection (PSII) is one of the most common complications after spine surgery. While in arthroplasty both haematoma formation and perioperative blood loss have been identified as risk factors for developing periprosthetic joint infections and preoperative anaemia has been associated with increased complication rates, literature on the aetiology of PSII remains limited. Methods We performed a matched-pair analysis of perioperative haemoglobin (Hb) and haematocrit (Hct) levels in aseptic and septic spine revision surgeries. 317 patients were included, 94 of which were classified as septic according to previously defined criteria. Patients were matched according to age, body mass index, diabetes, American Society of Anesthesiologists score and smoking habits. Descriptive summaries for septic and aseptic groups were analysed using Pearson chi-squared for categorical or Student t test for continuous variables. Results Fifty patients were matched and did not differ significantly in their reason for revision, mean length of hospital stay, blood transfusion, operating time, or number of levels operated on. While there was no significant difference in preoperative Hb or Hct levels, the mean difference between pre- and postoperative Hb was higher in the septic group (3.45 ± 1.25 vs. 2.82 ± 1.48 g/dL, p = 0.034). Conclusions We therefore show that the intraoperative Hb-trend is a predictor for the development of PSII independent of the amount of blood transfusions, operation time, number of spinal levels operated on and hospital length of stay, which is why strategies to reduce intraoperative blood loss in spine surgery need to be further studied. |
| Databáze: | OpenAIRE |
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