Konishi Kazumasa, Sano Hideto, Kawano Yosuke, Moroi Takehiko, Takeuchi Takumi, Takahashi Masahito, Hosogane Naobumi
Department of Orthopaedic Surgery, Kyorin University School of Medicine, Mitaka, Japan.
Asian Spine J. 2024 Dec;18(6):822-828. doi: 10.31616/asj.2024.0274. Epub 2024 Oct 22.
A retrospective study.
To identify factors involved in surgical site infections (SSIs) after spinal instrumentation surgery performed at a single institution.
SSIs after spinal instrumentation surgery are a serious complication. Despite reports on risk factors for SSIs in spine surgery, limited studies are related to spinal instrumentation surgery.
In total, 828 patients (338 males and 490 females; mean age, 65.0 years) who underwent spinal instrumentation surgery from 2013 to 2021 in Kyorin University School of Medicine were retrospectively investigated. Patients were divided into the SSI (group I) and non-SSI (group N) groups. Patient characteristics, comorbidity, laboratory, and surgical factors were investigated. Univariate analysis was performed for each item, and multivariate logistic regression analysis was performed for items with significant differences.
Fifteen patients (1.85%) had SSIs. Univariate analysis revealed significant differences between groups I and N in history of steroid use, serum albumin, C-reactive protein, number of fixed vertebrae, and perioperative blood transfusion. Multivariate logistic regression analysis showed that a history of steroid use (odds ratio [OR], 5.38; 95% confidence interval [CI], 1.41-20.49; p=0.014), serum albumin (OR, 0.34; 95% CI, 0.13-0.84; p=0.020), and perioperative blood transfusion (OR, 5.85; 95% CI, 1.46-23.50; p=0.013) were independent risk factors for SSIs.
The results of this study indicate that preoperative nutritional intervention, appropriate management of anemia, and intraoperative and postoperative bleeding control may decrease the incidence of SSIs. However, this study has several limitations, including its retrospective design, analysis of a few SSI cases, and inclusion of various surgical approaches and disease types. Future studies that address these limitations are desirable.
一项回顾性研究。
确定在单一机构进行脊柱内固定手术后手术部位感染（SSI）的相关因素。
脊柱内固定手术后的SSI是一种严重的并发症。尽管有关于脊柱手术中SSI危险因素的报道，但与脊柱内固定手术相关的研究有限。
对2013年至2021年在杏林大学医学院接受脊柱内固定手术的828例患者（338例男性和490例女性；平均年龄65.0岁）进行回顾性调查。患者分为SSI组（I组）和非SSI组（N组）。调查患者的特征、合并症、实验室检查和手术因素。对每个项目进行单因素分析，对有显著差异的项目进行多因素逻辑回归分析。
15例患者（1.85%）发生SSI。单因素分析显示，I组和N组在使用类固醇激素史、血清白蛋白、C反应蛋白、固定椎体数量和围手术期输血方面存在显著差异。多因素逻辑回归分析表明，使用类固醇激素史（比值比[OR]，5.38；95%置信区间[CI]，1.41 - 20.49；p = 0.014）、血清白蛋白（OR，0.34；95% CI，0.13 - 0.84；p = 0.020）和围手术期输血（OR，5.85；95% CI，1.46 - 23.50；p = 0.013）是SSI的独立危险因素。
本研究结果表明，术前营养干预、适当管理贫血以及术中及术后控制出血可能会降低SSI的发生率。然而，本研究有几个局限性，包括其回顾性设计、少量SSI病例分析以及纳入了各种手术方式和疾病类型。需要开展解决这些局限性的未来研究。
