The London Spine Unit : best situated spine centre in London
Published article
CONCLUSION: PCF, PLF, and lumbar laminectomy during the warm season had significantly higher odds of SSI, especially post-discharge. Reoperation rates for wound management were significantly elevated during the warm season for PLF. Identifying seasonal causes merits further investigation and may influence surgeon scheduling and expectations.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2022 Jan 27:S1878-8750(22)00114-0. doi: 10.1016/j.wneu.2022.01.100. Online ahead of print.
ABSTRACT
INTRODUCTION: Recent studies investigating seasonality as a risk factor for surgical site infections (SSI) after spine surgery show mixed results. This study utilizes national data to analyze seasonal effects on spine surgery SSIs.
METHODS: NSQIP data (2011-2018) was queried for posterior cervical fusions (PCF), cervical laminoplasties, posterior lumbar fusions (PLF), lumbar laminectomies, and deformity surgeries. Patients aged >89 and procedures for tumors, fractures, infections, and non-elective indications were excluded. Patients were divided into warm (admitted April-September) and cold (October-March) seasons. Demographics were compared using univariate analysis. Endpoints of SSI and reoperations for wound debridement/drainage were compared using multivariable logistic regression. Stratified analyses were performed by surgery type and pre- vs. post-discharge infections.
RESULTS: Overall (N=208,291) SSI was more likely in the warm season (OR=1.15, 95%CI=1.08-1.23, p<0.0001), as well as for PCF (OR=1.40, 95%CI=1.08-1.80, p=0.011), PLF (OR=1.15, 95%CI=1.04-1.28, p=0.006), and lumbar laminectomies (OR=1.13, 95%CI=1.03-1.25, p=0.014). Post-discharge infections were also more likely in the warm season overall (OR=1.15, 95%CI=1.07-1.23, p<0.0001), and for PCF (OR=1.32, 95%CI=1.01-1.73, p=0.041), PLF (OR=1.14, 95%CI=1.03-1.27, p=0.014), and lumbar laminectomies (OR=1.15, 95%CI=1.04-1.27, p=0.007). In-hospital infections were more likely during the warm season only for PCF (OR=2.54, 95%CI=1.06-6.10, p=0.037). Reoperations for infection were more likely during the warm season for PLF (OR=1.29, 95%CI=1.08-1.54, p=0.005).
CONCLUSION: PCF, PLF, and lumbar laminectomy during the warm season had significantly higher odds of SSI, especially post-discharge. Reoperation rates for wound management were significantly elevated during the warm season for PLF. Identifying seasonal causes merits further investigation and may influence surgeon scheduling and expectations.
PMID:35093573 | DOI:10.1016/j.wneu.2022.01.100
The London Spine Unit : best situated spine centre in London
Read the original publication:
Seasonal Effects on Surgical Site Infections Following Spine Surgery