Chronic steroid use, higher BMI among risk factors found to increase spine SSI rate
ORLANDO, Fla. — While the literature reports the surgical site infection rate can be as high as 18% for patients following posterior cervical surgery, a study presented here shed light on a number of risk factors that contribute to this increase in surgical site infections.
“We have identified a few different risk factors for postoperative infection following posterior cervical spine surgery. Patients should be counseled accordingly and future outcome measures should take this into account with regards to restratification,” Arjun S. Sebastian, MD, said.
Arjun S. Sebastian
The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) Participant Use Data File was used to identify 5,441 patients for the study. Overall, 3,724 patients had a posterior cervical decompression, 1,310 had a posterior cervical fusion and 407 underwent cervical laminoplasty.
Within 30 days, 160 patients were identified as having a SSI. Sebastian said the average diagnosis was made 2 weeks after surgery, and this resulted in a 36.9% readmission rate in 2011-2012.
While the study identified several risk factors for SSI, Sebastian said several factors also could reduce the rate of SSI in patients who undergo this procedure. Optimization of preoperative nutritional status, serum blood cell counts, and operative efficiency were all factors that could reduce SSI rates, he said.
The researchers found patients with a body mass index greater than 35, operations that last longer than 197 minutes, and chronic steroid use can result in higher rates of surgical site infection (SSI) for patients who undergo posterior cervical spine surgery.
Sebastian concluded that obese patients and patients on chronic steroid therapy should be counseled prior to their surgery about their elevated risk for SSI. He also said this is the first large database study, to his knowledge, to examine SSI rates in this cohort. – by Robert Linnehan
Sebastian AS. Paper #11. Presented at: Cervical Spine Research Society Annual Meeting; Dec. 4-6, 2014; Orlando, Fla.
Disclosure: Sebastian has no relevant financial disclosures.