Yang Yi-Fan, Yu Jun-Cheng, Xiao Zhen, Kang Yi-Jun, Zhou Bin
Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China.
Surg Infect (Larchmt). 2023 Dec;24(10):942-948. doi: 10.1089/sur.2023.051. Epub 2023 Nov 28.
A retrospective case-control study to determine the role of pre-operative systemic and local nutritional factors on patients developing a surgical site infection (SSI) after posterior lumbar interbody fusion (PLIF). Surgical site infection after PLIF remains a substantial cause of morbidity. The literature demonstrates the prognosis of surgical patients is associated with pre-operative nutritional status that not only includes systemic nutritional factors, such as prognostic nutritional index (PNI), body mass index (BMI), and serum albumin, but also local nutritional factors, such as subcutaneous fat thickness at the surgical site, including absolute fat thickness and relative fat thickness. However, the role of pre-operative nutrition status in SSI after PLIF surgery remains unclear. A retrospective review was performed on a consecutive cohort of 766 consecutive adult patients who underwent PLIF surgery for lumbar degenerative conditions between 2020 and 2021 at Second Xiangya Hospital. Previously identified risk factors as well as systemic and local nutritional factors nutritional factors were collected. Among the 766 patients, 38 had post-operative SSI including 15 superficial SSI and 23 deep SSI. Univariable analysis showed that body weight, BMI, PNI, serum albumin, and relative fat thickness differed between the SSI and non-SSI groups. Multivariable logistic regression analysis showed that pre-operative PNI and relative fat thickness were independently associated with SSI after PLIF surgery. Lower pre-operative PNI and higher relative fat thickness are independent risk factors for developing deep SSI after PLIF.
一项回顾性病例对照研究，以确定术前全身和局部营养因素对腰椎后路椎间融合术（PLIF）后发生手术部位感染（SSI）患者的作用。PLIF术后的手术部位感染仍然是发病的一个重要原因。文献表明，手术患者的预后与术前营养状况相关，这不仅包括全身营养因素，如预后营养指数（PNI）、体重指数（BMI）和血清白蛋白，还包括局部营养因素，如手术部位的皮下脂肪厚度，包括绝对脂肪厚度和相对脂肪厚度。然而，术前营养状况在PLIF手术后SSI中的作用仍不清楚。对2020年至2021年在湘雅二医院因腰椎退行性疾病接受PLIF手术的766例连续成年患者进行了回顾性研究。收集了先前确定的危险因素以及全身和局部营养因素。在766例患者中，38例发生术后SSI，包括15例浅表SSI和23例深部SSI。单因素分析显示，SSI组和非SSI组之间的体重、BMI、PNI、血清白蛋白和相对脂肪厚度存在差异。多因素logistic回归分析显示，术前PNI和相对脂肪厚度与PLIF手术后的SSI独立相关。术前较低的PNI和较高的相对脂肪厚度是PLIF术后发生深部SSI的独立危险因素。
