Preoperative Predictors of Spinal Infection within the National Surgical Quality Inpatient Database (original) (raw)

World Neurosurgery, 2016

Abstract

Surgical-site infections (SSIs) are a major cause of morbidity and mortality, increasing the length and cost of hospitalization. In patients undergoing spine surgery, there is limited large-scale data on patient-specific risk factors for SSIs. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was reviewed for all spinal operations between 2006 and 2012. The rates of 30 day surgical site infections were calculated, and univariate analysis of selected preoperative risk factors was performed. Multivariate analysis was then used to identify independent predictors of SSIs. 1110 of the 60179 patients (1.84%) had a postoperative wound infection. There were 527 (0.87%) deep and 590 (0.98%) superficial infections. Patients with infections had greater rates of sepsis, longer lengths of stay and more return visits to the operating room. Independent predictors of infection were female gender, inpatient status, insulin dependent diabetes, preoperative steroid use greater than 10 days, hematocrit less than 35, body mass index (BMI) greater than 30, wound class, ASA class, and operative duration. Analysis of a large national patient database revealed many independent risk factors for SSIs after spinal surgery. Some of these risk factors can be modified preoperatively to reduce the risk of postoperative infection.

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