Zhonghai Li1, Peng Liu2, Chunli Zhang3, Gang Xu4, Yu Zhang4, Yvang Chang4, Mozhen Liu4, Shuxun Hou3. 1. Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, People's Republic of China. Electronic address: lizhonghaispine@126.com. 2. Department of Orthopaedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, People's Republic of China. 3. Department of Orthopaedics, Fourth Medical Center of PLA General Hospital, Beijing, People's Republic of China. 4. Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China; Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Liaoning Province, People's Republic of China.
Abstract
PURPOSE: Surgical site infection (SSI) in spine surgery remains a significant cause of morbidity and prolonged hospitalization. We intended to document our experience in our center and to highlight possible factors influencing SSI in posterior lumbar fusion surgery. METHODS: Between June 2015 and March 2017, 448 consecutive patients with lumbar degenerative disease who underwent classic open transforaminal lumbar interbody fusion were enrolled in the study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analyses were performed to determine risk factors. RESULTS: There was a significant difference between groups in age (P = 0.001), body mass index (P < 0.001), subcutaneous fat thickness (P < 0.001), preoperative American Society of Anesthesiologists (ASA) score (P < 0.001), postoperative hemoglobin (P = 0.003), preoperative serum albumin (P < 0.001), operative time (P < 0.001), operated levels (P < 0.001), postoperative drainage (P = 0.004), time of draining (P < 0.001) and late-presenting dural tear (P = 0.008). Logistic regression analysis of these differences showed that thicker subcutaneous fat thickness, higher preoperative ASA score, lower preoperative serum albumin, and longer time of draining were significantly related to SSI (P < 0.05). CONCLUSIONS: The risk factors for SSI after lumbar fusion surgery are multifactorial. These data should provide a step toward the development of quality improvement measures aimed at reducing complications in high-risk patients. These factors may prove useful for patient counseling and for surgical planning.
PURPOSE: Surgical site infection (SSI) in spine surgery remains a significant cause of morbidity and prolonged hospitalization. We intended to document our experience in our center and to highlight possible factors influencing SSI in posterior lumbar fusion surgery. METHODS: Between June 2015 and March 2017, 448 consecutive patients with lumbar degenerative disease who underwent classic open transforaminal lumbar interbody fusion were enrolled in the study. We divided the patients into the SSI group and the non-SSI group and compared their patient-specific and procedure-specific factors. Univariate and multiple logistic regression analyses were performed to determine risk factors. RESULTS: There was a significant difference between groups in age (P = 0.001), body mass index (P < 0.001), subcutaneous fat thickness (P < 0.001), preoperative American Society of Anesthesiologists (ASA) score (P < 0.001), postoperative hemoglobin (P = 0.003), preoperative serum albumin (P < 0.001), operative time (P < 0.001), operated levels (P < 0.001), postoperative drainage (P = 0.004), time of draining (P < 0.001) and late-presenting dural tear (P = 0.008). Logistic regression analysis of these differences showed that thicker subcutaneous fat thickness, higher preoperative ASA score, lower preoperative serum albumin, and longer time of draining were significantly related to SSI (P < 0.05). CONCLUSIONS: The risk factors for SSI after lumbar fusion surgery are multifactorial. These data should provide a step toward the development of quality improvement measures aimed at reducing complications in high-risk patients. These factors may prove useful for patient counseling and for surgical planning.
Authors: Pascal Zehnder; Ulrike Held; Tim Pigott; Andrea Luca; Markus Loibl; Raluca Reitmeir; Tamás Fekete; Daniel Haschtmann; Anne F Mannion Journal: Eur Spine J Date: 2021-03-09 Impact factor: 3.134