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Published in: Journal of Orthopaedic Science 1/2015

01-01-2015 | Original Article

Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults

Authors: Satoshi Ogihara, Takashi Yamazaki, Toru Maruyama, Hiroyuki Oka, Kota Miyoshi, Seiichi Azuma, Takashi Yamada, Motoaki Murakami, Naohiro Kawamura, Nobuhiro Hara, Sei Terayama, Jiro Morii, So Kato, Sakae Tanaka

Published in: Journal of Orthopaedic Science | Issue 1/2015

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Abstract

Background

Surgical site infection is a serious and significant complication after spinal surgery and is associated with high morbidity rates, high healthcare costs and poor patient outcomes. Accurate identification of risk factors is essential for developing strategies to prevent devastating infections. The purpose of this study was to identify independent risk factors for surgical site infection among posterior thoracic and/or lumbar spinal surgery in adult patients using a prospective multicenter surveillance research method.

Methods

From July 2010 to June 2012, we performed a prospective surveillance study in adult patients who had developed surgical site infection after undergoing thoracic and/or lumbar posterior spinal surgery at 11 participating hospitals. Detailed preoperative and operative patient characteristics were prospectively recorded using a standardized data collection format. Surgical site infection was based on the definition established by the Centers for Disease Control and Prevention.

Results

A total of 2,736 consecutive adult patients were enrolled, of which 24 (0.9%) developed postoperative deep surgical site infection. Multivariate regression analysis indicated four independent risk factors. Preoperative steroid therapy (P = 0.001), spinal trauma (P = 0.048) and gender (male) (P = 0.02) were statistically significant independent patient-related risk factors, whereas an operating time ≥3 h (P < 0.001) was a surgery-related independent risk factor.

Conclusion

Preoperative steroid therapy, spinal trauma, male gender and an operating time ≥3 h were independent risk factors for deep surgical site infection after thoracic and/or lumbar spinal surgery in adult patients. Identification of these risk factors can be used to develop protocols aimed at decreasing the risk of surgical site infection.
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Metadata
Title
Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults
Authors
Satoshi Ogihara
Takashi Yamazaki
Toru Maruyama
Hiroyuki Oka
Kota Miyoshi
Seiichi Azuma
Takashi Yamada
Motoaki Murakami
Naohiro Kawamura
Nobuhiro Hara
Sei Terayama
Jiro Morii
So Kato
Sakae Tanaka
Publication date
01-01-2015
Publisher
Springer Japan
Published in
Journal of Orthopaedic Science / Issue 1/2015
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI
https://doi.org/10.1007/s00776-014-0669-1

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