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- Title
Incidence and Risk Factors for Infection After Operatively Treated Spinal Trauma - a Retrospective Review of 2,276 Patients From a Single Level I Trauma Institution.
- Authors
Bransford, Richard; Walker, Brett; Bellabarba, Carlo
- Abstract
Introduction: In the USA, it is estimated that 300 000-500 000 surgical site infections occur each year that are associated with increased healthcare related costs. Few studies have looked specifically at surgical site infections in spine trauma, however, rates in the literature suggest a 10-15% rate of post-operative wound infection. The purpose of our study was to examine a large group of patients who underwent surgical management of spine fractures to assess rates of infection and try to identify potential risk factors. Material and Methods: After obtaining IRB approval, patients were identified by searching specific CPT codes (22 851, 22 325, 22 326, 22 327) and linked ICD-9 codes (codes beginning with 8) from January 2005 to December 2015. From the larger group, we then identified patients with CPT codes 998.59 or 996.67 who required a secondary irrigation and debridement. We did not include patients who may have had a superficial infection managed non-operatively. Patients less than 18 years of age were excluded. A chart review of the identified patients documented a large set of demographics (age, sex, BMI, tobacco use, drug use, diabetes, fracture location, surgical approach, injury severity score (ISS), ICU stay, and overall length of stay to allow for comparison between those with infection and those without. Results: 2,276 adult patients underwent operative management of a spine fracture between January 2005 and December 2015. 637 (28%) were cervical injuries, 887 (39%) thoracic, and 752 (33%) lumbar with 6% undergoing an anterior approach, 92% a posterior approach, and 2% a combined anterior/posterior. Following index procedure, 64 patients (2.8%) required a secondary unanticipated return to the OR for irrigation and debridement secondary to infection. Anatomic location of injury (cervical, thoracic, lumbar) did not affect rate of infection in our study. Comparing those with infection to those without, there were no differences in age, BMI, or ISS. Smoking (p = 0.0009), drug use (p = 0.01) and ICU stay (p = 0.041) were all associated with higher rates of infection. Conclusion: This study in a single level I trauma institution shows a post-operative infection rate of 2.8% in patients undergoing operative management of spine fractures. Factors associated with increased infection rate included smoking, illicit drug use, and patients admitted to the ICU.
- Publication
Global Spine Journal, 2018, Vol 8, p129S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771030