Risk factors for surgical site infections following spinal fusion procedures: a case-control study.
Publication/Presentation Date
10-1-2011
Abstract
BACKGROUND: Spinal fusion procedures are associated with a significant rate of surgical site infection (SSI) (1%-12%). The goal of this study was to identify modifiable risk factors for spinal fusion SSIs at a large tertiary care center.
METHODS: A retrospective, case-control (1:3 ratio) analysis of SSIs following posterior spine fusion procedures was performed over a 1-year period. Clinical and surgical data were collected through electronic database and chart review. Variables were evaluated by univariate analysis and multivariable logistic regression.
RESULTS: In total, 57 deep SSIs were identified out of 1587 procedures (3.6%). Infections were diagnosed a mean of 13.5 ± 8 days postprocedure. Staphylococcus aureus was the predominant pathogen (63%); 1/3 of these isolates were methicillin resistant. Significant patient risk factors for infection by univariate analysis included ASA score >2 and male gender. Among surgical variables, infected cases had significantly higher proportions of staged procedures and thoracic level surgeries and had a greater number of vertebrae fused. Notably, infected fusion procedures had a longer duration of closed suction drains than controls (5.1 ± 2 days vs 3.4 ± 1 day, respectively; P < .001). Drain duration (unit odds ratio [OR], 1.6 per day drain present; 95% confidence interval [CI], 1.3-1.9), body mass index (OR, 1.1; 95% CI, 1.0-1.1), and male gender (OR, 2.7; 95% CI, 1.4-5.6) were significant risk factors in the multivariate analysis.
CONCLUSIONS: Prolonged duration of closed suction drains is a strong independent risk factor for SSI following instrumented spinal fusion procedures. Therefore, removing drains as early as possible may lower infection rates.
Volume
53
Issue
7
First Page
686
Last Page
692
ISSN
1537-6591
Published In/Presented At
Rao, S. B., Vasquez, G., Harrop, J., Maltenfort, M., Stein, N., Kaliyadan, G., Klibert, F., Epstein, R., Sharan, A., Vaccaro, A., & Flomenberg, P. (2011). Risk factors for surgical site infections following spinal fusion procedures: a case-control study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 53(7), 686–692. https://doi.org/10.1093/cid/cir506
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
21890772
Department(s)
Administration and Leadership
Document Type
Article