Predisposing factors for surgical site infection of spinal instrumentation surgery for diabetes patients

Satake, Kotaro; Kanemura, Tokumi; Matsumoto, Akiyuki; Yamaguchi, Hidetoshi; Ishikawa, Yoshimoto

doi:10.1007/s00586-013-2783-8

Cited by 47 publications

(38 citation statements)

References 24 publications

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“…In patients with diabetes mellitus, local changes in the tissues, along with neuropathy and angiopathy, increased the risk of infection. Previous studies reported that patients with poorly regulated blood glucose levels had a 10% -20.9% SSI rate (9,16,20). Our study supported these results.…”

Section: Risk Factors For Postoperative Infectionsupporting

confidence: 91%

Which Risk Factors are Important in Spinal Infection?

Eren¹,

Güzey²,

Kitiş

et al. 2017

Shafa Ortho J

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Background: Infection is the most common complication of spinal surgeries. Surgical site infection (SSI) can result in high hospitalisation costs owing to prolonged hospital stays, repeated surgeries and an increase in the frequency of pseudoarthrosis. Objectives: The purpose of this study was to identify the risk factors of SSI in patients treated with thoracolumbar posterior spinal instrumentation. Methods: Inclusion criteria were treated by posterior thoracolumbar stabilization with transpedicular screw and posterolateral fusion in the neurosurgery clinic between March 2006 and June 2009. Overall, 260 consecutive patients were identified and 239 patients included in this study. Risk factors that may cause increase of rate of SSI were evaluated.

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Section: Risk Factors For Postoperative Infectionsupporting

confidence: 91%

Which Risk Factors are Important in Spinal Infection?

Eren¹,

Güzey²,

Kitiş

et al. 2017

Shafa Ortho J

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show abstract

“…3-5 In patients with DM who underwent degenerative lumbar spine surgery, studies have shown reduced pain improvement, increased incidence of fusion complications and increased incidence of surgical site infections relative to those patients without DM. 4-6 A recent study from 2011, comparing patient centered outcomes in diabetics versus non-diabetics undergoing surgical intervention for common degenerative spinal diseases, showed some pain improvement following treatment of spinal stenosis and degenerative spondylolisthesis but no improvement following treatment of intervertebral disc (IVD) herniation. 7 However, this study did not stratify patients between varying levels of glycemic control, making it impossible to determine whether the severity of a patient’s diabetic condition also influenced surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Complications of Diabetes Mellitus on Patients Undergoing Degenerative Lumbar Spine Surgery

Guzman¹,

Iatridis²,

Skovrlj

et al. 2014

Spine

119

108

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Study Design Retrospective database analysis. Objective To assess the effect glycemic control has on perioperative morbidity and mortality in patients undergoing elective degenerative lumbar spine surgery. Summary of background data Diabetes Mellitus (DM) is a prevalent disease of glucose dysregulation that has been demonstrated to increase morbidity and mortality following spine surgery. However, there is limited understanding of whether glycemic control influences surgical outcomes in DM patients undergoing lumbar spine procedures for degenerative conditions. Methods The Nationwide Inpatient Sample was analyzed from 2002 to 2011. Hospitalizations were isolated based on International Classification of Diseases Ninth Revision, Clinical Modification procedural codes for lumbar spine surgery and diagnoses codes for degenerative conditions of the lumbar spine. Patients were then classified into three cohorts: controlled diabetics, uncontrolled diabetics and non-diabetics. Patient demographic data, acute complications and hospitalization outcomes were determined for each cohort. Results A total of 403,629 (15.7%) controlled diabetics and 19,421(0.75%) uncontrolled diabetics underwent degenerative lumbar spine surgery from 2002-2011. Relative to non-diabetics, uncontrolled diabetics had significantly increased odds of cardiac complications, deep venous thrombosis and post-operative shock; additionally, uncontrolled diabetics also had an increased mean length of stay (approximately 2.5 days), greater costs (1.3-fold) and a greater risk of inpatient mortality (odds ratio=2.6, 95% confidence interval=1.5-4.8, p < .0009). Controlled diabetics also had increased risk of acute complications and inpatient mortality when compared to non-diabetics, but not nearly to the same magnitude as uncontrolled diabetics. Conclusion Suboptimal glycemic control in diabetic patients undergoing degenerative lumbar spine surgery leads to increased risk of acute complications and poor outcomes. Patients with uncontrolled DM, or poor glucose control, may benefit from improving glycemic control prior to surgery.

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“…The amount of intraoperative blood loss is associated with higher rates of SSIs, for example, in lumbar fusion, 37 in pediatric patients, 38 and in diabetic patients. 39 In the DG we observed a higher blood loss (p ¼ 0.025) compared with the nDG. However, the subgroup of patients in the DG with SSIs showed no significant differences in blood loss (p ¼ 0.977) compared with the nDG.…”

Section: Surgical Site Infectionmentioning

confidence: 62%