Clinical Outcomes at One-year Follow-up for Patients With Surgical Site Infection After Spinal Fusion.

Authors

• Brian A Karamian
• Jennifer Mao
• Gregory R Toci
• Mark J Lambrechts
• Jose A Canseco
• Mahir A Qureshi
• Olivia Silveri
• Paul D Minetos
• Jack I Jallo
• Srinivas Prasad
• Joshua E Heller
• Ashwini D Sharan
• James S Harrop
• Barrett I Woods
• Ian David Kaye
• Alan Hilibrand
• Christopher K Kepler
• Alexander R Vaccaro
• Gregory D Schroeder

Publication/Presentation Date

8-1-2022

Abstract

STUDY DESIGN: Retrospective case-control study.

OBJECTIVE: To compare health-related quality of life outcomes at one-year follow-up between patients who did and did not develop surgical site infection (SSI) after thoracolumbar spinal fusion.

SUMMARY OF BACKGROUND DATA: SSI is among the most common healthcare-associated complications. As healthcare systems increasingly emphasize the value of delivered care, there is an increased need to understand the clinical impact of SSIs.

MATERIALS AND METHODS: A retrospective 3:1 (control:SSI) propensity-matched case-control study was conducted for adult patients who underwent thoracolumbar fusion from March 2014 to January 2020 at a single academic institution. Exclusion criteria included less than 18 years of age, incomplete preoperative and one-year postoperative patient-reported outcome measures, and revision surgery. Continuous and categorical data were compared via independent t tests and χ 2 tests, respectively. Intragroup analysis was performed using paired t tests. Regression analysis for ∆ patient-reported outcome measures (postoperative minus preoperative scores) controlled for demographics. The α was set at 0.05.

RESULTS: A total of 140 patients (105 control, 35 SSI) were included in final analysis. The infections group had a higher rate of readmission (100% vs. 0.95%, P < 0.001) and revision surgery (28.6% vs. 12.4%, P =0.048). Both groups improved significantly in Physical Component Score (control: P =0.013, SSI: P =0.039), Oswestry Disability Index (control: P < 0.001, SSI: P =0.001), Visual Analog Scale (VAS) Back (both, P < 0.001), and VAS Leg (control: P < 0.001, SSI: P =0.030). Only the control group improved in Mental Component Score ( P < 0.001 vs. SSI: P =0.228), but history of a SSI did not affect one-year improvement in ∆MCS-12 ( P =0.455) on regression analysis. VAS Leg improved significantly less in the infection group (-1.87 vs. -3.59, P =0.039), which was not significant after regression analysis (β=1.75, P =0.050).

CONCLUSION: Development of SSI after thoracolumbar fusion resulted in increased revision rates but did not influence patient improvement in one-year pain, functional disability, or physical and mental health status.

Volume

47

Issue

15

First Page

1055

Last Page

1061

ISSN

1528-1159

Published In/Presented At

Karamian, B. A., Mao, J., Toci, G. R., Lambrechts, M. J., Canseco, J. A., Qureshi, M. A., Silveri, O., Minetos, P. D., Jallo, J. I., Prasad, S., Heller, J. E., Sharan, A. D., Harrop, J. S., Woods, B. I., Kaye, I. D., Hilibrand, A., Kepler, C. K., Vaccaro, A. R., & Schroeder, G. D. (2022). Clinical Outcomes at One-year Follow-up for Patients With Surgical Site Infection After Spinal Fusion. Spine, 47(15), 1055–1061. https://doi.org/10.1097/BRS.0000000000004394

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

35797595

Department(s)

Administration and Leadership

Document Type

Article