The Outcome Horizon Is Optimistic After Infection

Abstract

he article by Karamian et al provides us with insight on the fate of patients who develop surgical site infection (SSI) after thoracolumbar spinal fusion. Notwithstanding the patient morbidity associated with SSI, this topic continues to be relevant for healthcare value measurement. Prior research on the effect of SSI on patient outcomes after spinal fusion is mixed. 1,2 The advantages of this study include a larger sample size, bias reduction through propensity score matching, and utilization of a standardized SSI definition. Importantly, the patient-reported outcome measures (PROMs) selected for this study include disease-specific forms (ODI) alongside broader physical function and mental health (physical component summary [PCS] and MCS) forms. The authors found that the development of SSI did not lead to a difference in outcome scores at 1-year follow-up from spinal fusion. These findings mirror those recently published by Urquhart et al, 3 who report the negative impact of SSI after surgery resolves at 1-year follow-up using the same outcome measures.Notable secondary findings in this paper include a wide spectrum of causative organisms with a predominance of gram negative organisms and a stubbornly high SSI rate.