PT  - JOURNAL ARTICLE
AU  - SALMONS, HAROLD I.
AU  - LENDNER, MAYAN
AU  - DIVI, SRIKANTH N.
AU  - DWORKIN, MYLES
AU  - MCKENZIE, JAMES
AU  - TARAZONA, DANIEL
AU  - GALA, ZACHARY
AU  - LENDNER, YOVEL
AU  - WOODS, BARRETT
AU  - KAYE, DAVID
AU  - SAVAGE, JASON
AU  - KEPLER, CHRISTOPHER
AU  - KURD, MARK
AU  - HSU, VICTOR
AU  - RADCLIFF, KRIS
AU  - RIHN, JEFF
AU  - ANDERSON, GREG
AU  - HILIBRAND, ALAN
AU  - VACCARO, ALEX
AU  - SCHROEDER, GREGORY
TI  - Effects of Operating Room Size on Surgical Site Infection Following Lumbar Fusion Surgery
AID  - 10.14444/6057
DP  - 2019 Oct 01
TA  - International Journal of Spine Surgery
PG  - 423--428
VI  - 13
IP  - 5
4099  - https://www.ijssurgery.com/content/13/5/423.short
4100  - https://www.ijssurgery.com/content/13/5/423.full
SO  - Int J Spine Surg2019 Oct 01; 13
AB  - Background: Surgical site infections (SSIs) represent a devastating complication after spine surgery. Many factors have been identified, but the influence of operating room (OR) size on infection rate has not been assessed.Methods: Two thousand five hundred and twenty-three patients who underwent open lumbar spine fusion at a single institution between 2010 and 2016 were included. Patients were dichotomized into large versus small groups based on OR volume. Bivariate logistic regression and a final multivariate model following a multicollinearity check were used to calculate odds of infection for all variables.Results: A total of 63 patients (2.5%) developed SSIs with 46 (73%) in the larger OR group and 17 (27%) in the smaller OR group. The rate of SSIs in larger ORs was 3.02% compared with 1.81% in smaller ORs. Significant parameters impacting SSI in bivariate analysis included an earlier year of surgery, BMI > 30, more comorbidities, more levels decompressed and fused, smoking, and larger OR volumes. Multivariate analysis identified BMI > 30, Elixhauser scores, smoking, and increasing levels decompressed as significant predictors. Topical vancomycin was found to significantly decrease rate of infection in both analyses.Conclusions: OR size (large versus small) was ultimately not a significant predictor of infection related to rates of SSIs, although it did show a clinical trend toward significance, suggesting association. Future prospective analysis is warranted.Level of Evidence: 3.