Risk Factors for Postoperative Infections After Single-Level Lumbar Fusion Surgery

Lim, Seokchun; Edelstein, Adam I.; Patel, Alpesh A.; Kim, Bobby D.; Kim, John Y.S.

doi:10.1097/brs.0000000000000608

Cited by 67 publications

(43 citation statements)

References 37 publications

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“…[34][35][36][37][38][39][40] Regarding surgical complications specifically, multiple studies have demonstrated an association between obesity and the incidence of surgical site infections. 35,38,39,41,42 The increased risk for surgical site infections in obese patients has been attributed to the increased risk of fat necrosis in this population, serving as a nidus for infection. Additionally, when utilizing a posterior approach, obese patients can create a more technically demanding procedure due to limited patient mobility and increased difficulty during surgical exposure.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2020

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Background: The prevention of perioperative and postoperative complications is necessary to avoid poor postoperative outcomes and increased costs. Previous investigations have identified risk factors for complications after various spine procedures, but no such study exists in a population solely undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this study is to determine risk factors for the development of complications up to 2 years after MIS TLIF procedures. Methods: Patients who underwent primary, single-level MIS TLIF from 2007 to 2016 were retrospectively reviewed. The incidence of medical and surgical complications up to 2 years postoperatively was determined. Patients were categorized according to demographic, comorbidity, and procedural characteristics. Bivariate Poisson regression with robust error variance was used to determine if an association existed between patient characteristics and complication incidence. A final multivariate model including all patient characteristics as controls was created using backwards, stepwise regression until only those variables with P , .05 remained. Results: 390 patients were analyzed. Upon bivariate analysis, age .50 years (P ¼ .025), diabetes mellitus (P ¼ .001), and operative duration .105 minutes (P ¼ .016) were associated with increased medical complication rates. Regarding surgical complications, age 50 years (P , .001), obesity (P ¼ .012), and diabetes mellitus (P ¼ .042) were identified as risk factors on bivariate analysis. Upon final multivariate analysis, operative time .105 minutes (P ¼ .009) and diabetes mellitus (P ¼ .001) were independent risk factors for medical complications. Independent risk factors for surgical complications on multivariate analysis included age 50 years (P , .001), diabetes mellitus (P ¼ .002), and obesity (P ¼ .030). Conclusions: Diabetic patients and those who underwent longer operations were at increased risk of medical complications, while younger patients, obese patients and those also with diabetes mellitus were at increased risk of surgical complications up to 2 years after MIS TLIF. Practitioners can use this information to identify patients who require preventative care before their procedure or increased postoperative vigilance and monitoring after single-level MIS TLIF.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

et al. 2020

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“…Multiple risk factors have been identified as predictors of SSI including greater than one liter of intraoperative blood loss, operative time greater than 3 hours, inpatient stay greater than 1 week prior to index operation, and preoperative patient characteristics including smoking, alcohol abuse, malnutrition, diabetes and long-term steroid use [2–5]. The USA National Healthcare Safety Network reported a mean SSI rate of 0.7% to 4.2% for spinal fusions and 0.7% to 2.3% for laminectomies [6].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for surgical site infection after instrumented fixation in spine trauma

Cooper

Glenn

Martin

et al. 2016

Journal of Clinical Neuroscience

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Surgical site infection (SSI) represents a significant complication after instrumented fixation in spine changes have emphasized early fracture correction, shortened intraoperative times, early ambulation, and prompt nutritional supplementation. This retrospective study evaluates the senior author’s experience of instrumented spinal trauma SSI occurring at a single Level I trauma center over two equal and contiguous time periods, 2005–2007 (before nutritional supplementation was added to the institutional protocol) and 2008–2010 (after nutritional supplementation was added). This study assessed whether SSI varied depending on the primary surgical site and/or by the chosen approach. Lastly, the incidence of SSI among demographic and other clinical variables was evaluated. In total, 358 patients underwent an index procedure for spinal trauma correction. Fourteen patients developed a SSI requiring reoperation for an incidence of 4.0%. In assessing nutritional supplementation, the probability of infection tended to be lower in the supplemented group (3.7%) than the pre-supplement group (4.3%), but this did not reach significance. The difference in approach for the cervical spine was statistically significant (p = 0.045) with rates of infection via posterior approach at 8.1% and no infections via anterior approach. Presence of comorbidities (p = 0.03) and time to surgery >3 days (p = 0.006) were predictors of developing SSI. Benefit is shown from early surgical correction of spinal trauma patients in the reduction of postoperative SSI. Nutritional supplementation may provide a small reduction in infections in the spine trauma population.

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“…4,5 One of the few studies examining this topic was conducted by Lim et al 4 These authors found that the incidence of pneumonia after one-level lumbar fusion procedures was 0.6%. A second study reported that the in-hospital incidence of pneumonia after lumbar fusion procedures was 1.05%.…”

mentioning

confidence: 99%

Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures

Bohl

Mayo

Massel

et al. 2016

Spine

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Risk Factors for Postoperative Infections After Single-Level Lumbar Fusion Surgery

Abstract: 3.

Cited by 67 publications

References 37 publications

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Risk Factors for Medical and Surgical Complications After Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion

Risk factors for surgical site infection after instrumented fixation in spine trauma

Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures

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