Risk factors for surgical site infection in spinal surgery

Margaret A. Olsen, Jennie Mayfield, Carl Lauryssen, Louis B. Polish, Marilyn Jones, Joshua Vest, Victoria J. Fraser

Research output: Contribution to journalArticle

295 Citations (Scopus)

Abstract

Object. The objective of this study was to identify specific independent risk factors for surgical site infections (SSIs) occurring after laminectomy or spinal fusion. Methods. The authors performed a retrospective case-control study of data obtained in patients between 1996 and 1999 who had undergone laminectomy and/or spinal fusion. Forty-one patients with SSI or meningitis were identified, and data were compared with those acquired in 178 uninfected control patients. Risk factors for SSI were determined using univariate analyses and multivariate logistic regression. The spinal surgery-related SSI rate (incisional and organ space) during the 4-year study period was 2.8%, Independent risk factors for SSI identified by multivariate analysis were postoperative incontinence (odds ratio [OR] 8.2, 95% confidence interval [CI] 2.9-22.8), posterior approach (OR 8.2, 95% CI 2-33.5), procedure for tumor resection (OR 6.2, 95% CI 1.7-22.3), and morbid obesity (OR 5.2, 95% CI 1.9-14.2). In patients with SSI the postoperative hospital length of stay was significantly longer than that in uninfected patients (median 6 and 3 days, respectively; p < 0.001) and were readmitted to the hospital for a median additional 6 days for treatment of their infection. Repeated surgery due to the infection was required in the majority (73%) of infected patients. Conclusions. Postoperative incontinence, posterior approach, surgery for tumor resection, and morbid obesity were independent risk factors predictive of SSI following spinal surgery. Interventions to reduce the risk for these potentially devastating infections need to be developed.

Original languageEnglish (US)
Pages (from-to)149-155
Number of pages7
JournalJournal of Neurosurgery
Volume98
Issue number2 SUPPL.
StatePublished - Mar 1 2003
Externally publishedYes

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Surgical Wound Infection
Odds Ratio
Confidence Intervals
Spinal Fusion
Laminectomy
Morbid Obesity
Length of Stay
Multivariate Analysis
Infection
Meningitis
Case-Control Studies
Neoplasms
Logistic Models

Keywords

  • Infection
  • Laminectomy
  • Risk factor
  • Spinal fusion

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Olsen, M. A., Mayfield, J., Lauryssen, C., Polish, L. B., Jones, M., Vest, J., & Fraser, V. J. (2003). Risk factors for surgical site infection in spinal surgery. Journal of Neurosurgery, 98(2 SUPPL.), 149-155.

Risk factors for surgical site infection in spinal surgery. / Olsen, Margaret A.; Mayfield, Jennie; Lauryssen, Carl; Polish, Louis B.; Jones, Marilyn; Vest, Joshua; Fraser, Victoria J.

In: Journal of Neurosurgery, Vol. 98, No. 2 SUPPL., 01.03.2003, p. 149-155.

Research output: Contribution to journalArticle

Olsen, MA, Mayfield, J, Lauryssen, C, Polish, LB, Jones, M, Vest, J & Fraser, VJ 2003, 'Risk factors for surgical site infection in spinal surgery', Journal of Neurosurgery, vol. 98, no. 2 SUPPL., pp. 149-155.
Olsen MA, Mayfield J, Lauryssen C, Polish LB, Jones M, Vest J et al. Risk factors for surgical site infection in spinal surgery. Journal of Neurosurgery. 2003 Mar 1;98(2 SUPPL.):149-155.
Olsen, Margaret A. ; Mayfield, Jennie ; Lauryssen, Carl ; Polish, Louis B. ; Jones, Marilyn ; Vest, Joshua ; Fraser, Victoria J. / Risk factors for surgical site infection in spinal surgery. In: Journal of Neurosurgery. 2003 ; Vol. 98, No. 2 SUPPL. pp. 149-155.
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