Risk factors for wound complications following spine surgery.
Publication/Presentation Date
1-1-2017
Abstract
BACKGROUND: Wound complications, including surgical site infections (SSIs) and wound dehiscence, are among the most common complications following spine surgery often leading to readmission. The authors sought to identify preoperative characteristics predictive of wound complications after spine surgery.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program database for years 2012-2014 was reviewed for patients undergoing spine surgery, defined by the Current Procedural Terminology codes. Forty-four preoperative and surgical characteristics were analyzed for associations with wound complications.
RESULTS: Of the 99,152 patients included in this study, 2.2% experienced at least one wound complication (superficial SSI: 0.9%, deep SSI: 0.8%, organ space SSI: 0.4%, and dehiscence: 0.3%). Multivariate binary logistic regression testing found 10 preoperative characteristics associated with wound complications: body mass index ≥30, smoker, female, chronic steroid use, hematocrit3 hours. A risk score for each patient was created from the number of characteristics present. Receiver operating characteristic curves of the unweighted and weighted risk scores generated areas under the curve of 0.701 (95% CI: 0.690-0.713) and 0.715 (95% CI: 0.704-0.726), respectively. Patients with unweighted risk scores >7 were 25-fold more likely to develop a wound complication compared to patients with scores of 0. In addition, mortality rate, reoperation rate, and total length of stay each increased nearly 10-fold with increasing risk score.
CONCLUSION: This study introduces a novel risk score for the development of wound dehiscence and SSIs in patients undergoing spine surgery, using new risk factors identified here.
Volume
8
First Page
269
Last Page
269
ISSN
2229-5097
Published In/Presented At
Piper, K. F., Tomlinson, S. B., Santangelo, G., Van Galen, J., DeAndrea-Lazarus, I., Towner, J., Kimmell, K. T., Silberstein, H., & Vates, G. E. (2017). Risk factors for wound complications following spine surgery. Surgical neurology international, 8, 269. https://doi.org/10.4103/sni.sni_306_17
Disciplines
Medicine and Health Sciences
PubMedID
29184720
Department(s)
Fellows and Residents
Document Type
Article