Using administrative data to determine rates of surgical site infections following spinal fusion and laminectomy procedures

Crocker, Alysha; Kornilo, Anna; Conly, John; Henderson, Elizabeth; Rennert-May, Elissa; Leal, Jenine

doi:10.1016/j.ajic.2020.10.010

Cited by 8 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Open laminectomy, which is a classic surgical method for the treatment of LSS, can completely decompress the stenosis of the spinal canal and effectively relieve symptoms [5]. However, as a result of extensive dissection of paravertebral muscles and massive destruction of the posterior osseoligamentous complex, the incidence of postoperative paravertebral muscle denervation atrophy, infection, instability, and other complications remains high, which leads to untenable patient suffering [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Large Channel Endoscopic Systems with Full Endoscopic Visualization Technique in Lumbar Central Spinal Stenosis: A Retrospective Cohort Study

et al. 2022

View full text Add to dashboard Cite

Introduction: Recently, large channel endoscopic systems and full endoscopic visualization technique have been used to perform unilateral laminotomy for bilateral decompression (ULBD) treatment for lumbar central spinal stenosis (LCSS). However, various endoscopic systems possess different design parameters, which may affect the technical points and treatment outcomes. The object of this retrospective study was to compare the efficiency, safety, and effectiveness of ULBD under the iLESSYS Delta system versus the Endo-Surgi Plus system. Methods: In the period from October 2020 to April 2021, ULBD was performed using the iLESSYS Delta system or Endo-Surgi Plus system to treat LCSS. Patients were classified into two groups based on the endoscopy system employed. Patient demographics, perioperative indexes, complications, and imaging characteristics were reviewed. Clinical outcomes were quantified using back and leg visual analog scale (VAS) scores and Oswestry Disability Index (ODI) at the time points of follow-up. Results: Thirty-two patients were assigned to the iLESSYS Delta system group and 37 to the Endo-Surgi Plus system group. In the comparison between the two groups, the Endo-Surgi Plus system possessed a shorter incision length and operation time (p \ 0.005), and no statistical differences in other aspects were observed. The dural sacs of both groups were significantly expanded postoperatively compared to preoperatively (p \ 0.001). Both groups experienced improvements in VAS and ODI scores at all time points (p \ 0.001) and equally low frequency of complications.Conclusions: Current research suggests that both the Endo-Surgi Plus system and iLESSYS Delta system achieved favorable high safety and clinical outcomes in ULBD for treatment of Shuo Han and Xiangxu Zeng contributed equally to this work and share their first authorship.

show abstract

Section: Introductionmentioning

confidence: 99%

Clinical Application of Large Channel Endoscopic Systems with Full Endoscopic Visualization Technique in Lumbar Central Spinal Stenosis: A Retrospective Cohort Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…SSI was assessed by querying the EMR for ICD-10 codes corresponding to possible SSIs (defined as ICD-10 codes beginning with T81.4, T84.5, T84.6, T84.7, and T85.73). 24 Patients for whom a corresponding new ICD-10 code was documented during the interval of interest were manually reviewed. Any patient who was prescribed antibiotics within 90 days of a neurosurgical operation for a presumed or proven infection at the surgical site was counted as having an SSI, in accordance with CDC definitions.…”

Section: Data Collection and Definitionsmentioning

confidence: 99%

The effects of avoiding extended antimicrobial drain prophylaxis on Clostridioides difficile and postprocedural infection rates: a 5-year retrospective

Marino

Robinson

Durden

et al. 2022

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE Postprocedural infection is a consequential complication of neurosurgical intervention. Periprocedural antimicrobial prophylaxis is routinely administered to prevent infection, and in some cases, continued for extended periods while surgical drains remain in place. However, there is little evidence that extended antimicrobial administration is necessary to reduce postprocedural infection, and extended antimicrobials can be associated with harm, such as Clostridioides difficile infection. The authors sought to evaluate whether shortening the duration of postprocedural antimicrobial prophylaxis would decrease the incidence of C. difficile infection without increasing the incidence of postprocedural infection. METHODS In this retrospective study, two general neurosurgical cohorts were examined. In one cohort, postoperative antimicrobial prophylaxis was limited to 24 hours; in the other, some patients received extended postoperative antimicrobial prophylaxis while surgical drains or external ventricular drains (EVDs) remained in place. Rates of infection with C. difficile as well as postprocedural infection after surgery and EVD placement were compared. RESULTS Seven thousand two hundred four patients undergoing 8586 surgical procedures and 413 EVD placements were reviewed. The incidence of C. difficile infection decreased significantly from 0.5% per procedural encounter to 0.07% with the discontinuation of extended postprocedural antibiotics within 90 days of a procedure. Rates of postprocedural infection and EVD infection did not significantly change. Results were similar in subgroups of patients with closed suction drains as well as cranial and spine subgroups. CONCLUSIONS Discontinuation of extended antimicrobial prophylaxis was associated with a significant decrease in the incidence of C. difficile infection without a concomitant change in postprocedural infections or EVD-associated infection. This study provides evidence in support of specialtfy-wide discontinuation of extended postoperative antimicrobial prophylaxis, even in the presence of closed suction drains.

show abstract

“…Identifying SSIs from large population-based databases can improve the completeness, accuracy, and efficiency of SSI surveillance programs [ 7 ]. In Canada, SSI case identification relies on International Classification of Diseases (ICD) codes [ 8 ], sometimes followed by a comprehensive chart review to confirm the presence of SSIs [ 7 , 9 ]. As such, traditional surveillance methods rely on manual chart review by trained reviewers.…”

Section: Introductionmentioning

confidence: 99%

Development of machine learning models for the detection of surgical site infections following total hip and knee arthroplasty: a multicenter cohort study

Wu,

Cheligeer,

Southern

et al. 2023

Antimicrob Resist Infect Control

Self Cite

View full text Add to dashboard Cite

Background Population based surveillance of surgical site infections (SSIs) requires precise case-finding strategies. We sought to develop and validate machine learning models to automate the process of complex (deep incisional/organ space) SSIs case detection. Methods This retrospective cohort study included adult patients (age ≥ 18 years) admitted to Calgary, Canada acute care hospitals who underwent primary total elective hip (THA) or knee (TKA) arthroplasty between Jan 1st, 2013 and Aug 31st, 2020. True SSI conditions were judged by the Alberta Health Services Infection Prevention and Control (IPC) program staff. Using the IPC cases as labels, we developed and validated nine XGBoost models to identify deep incisional SSIs, organ space SSIs and complex SSIs using administrative data, electronic medical records (EMR) free text data, and both. The performance of machine learning models was assessed by sensitivity, specificity, positive predictive value, negative predictive value, F1 score, the area under the receiver operating characteristic curve (ROC AUC) and the area under the precision–recall curve (PR AUC). In addition, a bootstrap 95% confidence interval (95% CI) was calculated. Results There were 22,059 unique patients with 27,360 hospital admissions resulting in 88,351 days of hospital stay. This included 16,561 (60.5%) TKA and 10,799 (39.5%) THA procedures. There were 235 ascertained SSIs. Of them, 77 (32.8%) were superficial incisional SSIs, 57 (24.3%) were deep incisional SSIs, and 101 (42.9%) were organ space SSIs. The incidence rates were 0.37 for superficial incisional SSIs, 0.21 for deep incisional SSIs, 0.37 for organ space and 0.58 for complex SSIs per 100 surgical procedures, respectively. The optimal XGBoost models using administrative data and text data combined achieved a ROC AUC of 0.906 (95% CI 0.835–0.978), PR AUC of 0.637 (95% CI 0.528–0.746), and F1 score of 0.79 (0.67–0.90). Conclusions Our findings suggest machine learning models derived from administrative data and EMR text data achieved high performance and can be used to automate the detection of complex SSIs.

show abstract

Using administrative data to determine rates of surgical site infections following spinal fusion and laminectomy procedures

Cited by 8 publications

References 25 publications

Clinical Application of Large Channel Endoscopic Systems with Full Endoscopic Visualization Technique in Lumbar Central Spinal Stenosis: A Retrospective Cohort Study

Clinical Application of Large Channel Endoscopic Systems with Full Endoscopic Visualization Technique in Lumbar Central Spinal Stenosis: A Retrospective Cohort Study

The effects of avoiding extended antimicrobial drain prophylaxis on Clostridioides difficile and postprocedural infection rates: a 5-year retrospective

Development of machine learning models for the detection of surgical site infections following total hip and knee arthroplasty: a multicenter cohort study

Contact Info

Product

Resources

About