RT Journal Article
SR Electronic
T1 Risk Factors for Acute Surgical Site Infection after Spinal Instrumentation Procedures: A Case-Control Study
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 1025
OP 1030
DO 10.14444/8130
VO 15
IS 5
A1 Amorim-Barbosa, Tiago
A1 Sousa, Ricardo
A1 Rodrigues-Pinto, Ricardo
A1 Oliveira, António
YR 2021
UL https://www.ijssurgery.com/content/15/5/1025.abstract
AB Background: Surgical site infection (SSI) prevalence in spinal instrumentation varies, depending on patient and surgery factors. This study aims to identify patient- and procedure-related factors associated with SSI after spinal instrumentation in 3 patient-specific groups: those undergoing surgery for degenerative, trauma-related, and pediatric deformity conditions.Methods: A case-control (1:2 ratio) analysis of SSI after spinal instrumentation, from 2009 to 2017, in a University Hospital and Spinal Trauma Centre was performed.Results: From a total of 2582 surgeries, 33 cases (1.3%) were identified with SSI according to study inclusion criteria: 14 (out of 1326) in the degenerative group, 11 (out of 207) in the trauma group, and 8 (out of 850) in the pediatric deformity group. Cases were matched with controls (n = 66) of the same group. Univariate analysis identified procedure and anesthesia duration in the degenerative group (P = .032 and .038, respectively), age (P = .014) and need for intraoperative and postoperative blood transfusions (both P = .039) in the trauma group and American Society of Anesthesiologists score (P = .022) and neuromuscular scoliosis (P = .002) in the pediatric deformity group as associated with SSI. After multivariate analysis, procedure duration was independently associated with SSI in degenerative surgery (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.03–4.82) and procedure duration (OR, 3.79; 95% CI, 1.27–11.32) and number of levels instrumented (OR, 11.77; 95% CI, 1.55–89.40) in the trauma group.Conclusions: This study identified procedure duration as a risk factor for SSI after spinal instrumentation in degenerative and trauma spine surgery and the number of levels instrumented in trauma spine surgery. Awareness of these factors will help develop strategies to improve patient and health system overall outcomes.