Incidence and risk factors for infection in spine surgery: A prospective multicenter study of 1764 instrumented spinal procedures
| Autor: | Zhenbin Wang, Kahaer Aikenmu, Enfeng Zhang, Laiyong Tu, Ge Chu, Wenfei Gu, Jiang Zhao, Zhiquan Liang |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Epidemiology 03 medical and health sciences 0302 clinical medicine Degenerative disease Acquired immunodeficiency syndrome (AIDS) Risk Factors medicine Humans Surgical Wound Infection Orthopedic Procedures Prospective Studies 030212 general & internal medicine Prospective cohort study Aged Univariate analysis business.industry Incidence Health Policy Medical record Incidence (epidemiology) Public Health Environmental and Occupational Health Middle Aged medicine.disease Surgery Infectious Diseases Wounds and Injuries Female Spinal Diseases Complication business 030217 neurology & neurosurgery |
| Zdroj: | American Journal of Infection Control. 46:8-13 |
| ISSN: | 0196-6553 |
| Popis: | Background Surgical site infection (SSI) is a common complication in spinal surgery, imposing a high burden on patients and society. However, information about its characteristics and related risk factors is limited. We designed this prospective, multicenter study to address this issue. Methods : From January 2015 through February 2016, a total of 1764 patients who had spinal trauma or degenerative spinal diseases were treated with instrumented surgeries and followed up for 1 year with complete data. Data on all patients were abstracted from electronic medical records, and SSIs were prospectively inspected and diagnosed by surgeons in our department. Any disagreement among them was settled by the leader of this study. SPSS 19.0 was used to perform the analyses. Results A total of 58 patients (3.3%, 58 of 1764) developed SSI; 1.1% had deep SSI, and 2.2% had superficial SSI. Of these, 60.6% (21 of 33) had a polymicrobial cause. Most of them (51 of 58) occurred during hospitalization. The median occurrence time was 3 days after operation (range: 1–123 days). SSI significantly prolonged hospital stays, by 9.3 days on average. The univariate analysis revealed reason for surgery as the only significant risk factor. The multivariate analysis, however, revealed 8 significant risk factors, including higher BMI, surgical site (cervical), surgical approach (posterior), surgery performed in summer, reasons for surgery (degenerative disease), autograft for fusion and fixation, and higher preoperative platelet level. Conclusion Identification of these risk factors aids in stratifying preoperative risk to reduce SSI incidence. In addition, the results could be used in counseling patients and their families during the consent process. |
| Databáze: | OpenAIRE |
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