Case-control study of risk factors for surgical site infection after three-column osteotomy for spine deformity

Rafael De La Garza Ramos, Jonathan Nakhla, Rani Nasser, Niketh Bhashyam, Merritt D. Kinon, Reza Yassari

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

AIM: To investigate risk factors for surgical site infection (SSI) after three-column osteotomy (3CO) for spinal deformity. MATERIAL and METHODS: The American College of Surgeons National Surgical Quality Improvement Program database (2012- 2014) was reviewed. We included adult patients who underwent 3CO and compared pertinent cases (SSI) to controls (no SSI) in terms of preoperative and operative characteristics. Patients with clean/contaminated, contaminated, and dirty/infected wounds were excluded. A stepwise multivariate regression was used to identify independent predictors of SSI, with results presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: There were 293 patients who underwent 3CO for spinal deformity, out of whom 15 (5.1%) developed a SSI during the 30- day follow-up period. Of the 15 patients with SSI, 10 underwent reoperation (66.7%) within 30 days. Compared to controls, patients in the SSI group were more likely to be obese (p=0.030), have a higher American Society of Anesthesiologists (ASA) physical status class (p=0.051) and be more likely to undergo multilevel 3CO (p=0.013). After controlling for obesity, bleeding disorder, deformity type, ASA class, preoperative anemia, and multilevel procedures, Class II obesity (OR 4.98; 95% CI, 1.24 - 19.94; p=0.023) and multilevel 3CO (OR 4.71; 95% CI, 1.30 - 16.94; p=0.018) were significant predictors of SSI occurrence. CONCLUSION: Patients with Class II obesity and patients who undergo multilevel osteotomy may be at a significantly increased risk of developing a SSI within 30 days after 3CO for spine deformity.

Original languageEnglish (US)
Pages (from-to)597-601
Number of pages5
JournalTurkish Neurosurgery
Volume28
Issue number4
DOIs
StatePublished - Jan 1 2018

Fingerprint

Surgical Wound Infection
Osteotomy
Case-Control Studies
Spine
Obesity
Odds Ratio
Confidence Intervals
Infection Control
Quality Improvement
Reoperation
Anemia
Databases
Hemorrhage

Keywords

  • National Surgical Quality Improvement Program
  • Spinal deformity
  • Surgical site infection
  • Three-column osteotomy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Case-control study of risk factors for surgical site infection after three-column osteotomy for spine deformity. / De La Garza Ramos, Rafael; Nakhla, Jonathan; Nasser, Rani; Bhashyam, Niketh; Kinon, Merritt D.; Yassari, Reza.

In: Turkish Neurosurgery, Vol. 28, No. 4, 01.01.2018, p. 597-601.

Research output: Contribution to journalArticle

De La Garza Ramos, Rafael ; Nakhla, Jonathan ; Nasser, Rani ; Bhashyam, Niketh ; Kinon, Merritt D. ; Yassari, Reza. / Case-control study of risk factors for surgical site infection after three-column osteotomy for spine deformity. In: Turkish Neurosurgery. 2018 ; Vol. 28, No. 4. pp. 597-601.
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abstract = "AIM: To investigate risk factors for surgical site infection (SSI) after three-column osteotomy (3CO) for spinal deformity. MATERIAL and METHODS: The American College of Surgeons National Surgical Quality Improvement Program database (2012- 2014) was reviewed. We included adult patients who underwent 3CO and compared pertinent cases (SSI) to controls (no SSI) in terms of preoperative and operative characteristics. Patients with clean/contaminated, contaminated, and dirty/infected wounds were excluded. A stepwise multivariate regression was used to identify independent predictors of SSI, with results presented as odds ratios (OR) with 95{\%} confidence intervals (CI). RESULTS: There were 293 patients who underwent 3CO for spinal deformity, out of whom 15 (5.1{\%}) developed a SSI during the 30- day follow-up period. Of the 15 patients with SSI, 10 underwent reoperation (66.7{\%}) within 30 days. Compared to controls, patients in the SSI group were more likely to be obese (p=0.030), have a higher American Society of Anesthesiologists (ASA) physical status class (p=0.051) and be more likely to undergo multilevel 3CO (p=0.013). After controlling for obesity, bleeding disorder, deformity type, ASA class, preoperative anemia, and multilevel procedures, Class II obesity (OR 4.98; 95{\%} CI, 1.24 - 19.94; p=0.023) and multilevel 3CO (OR 4.71; 95{\%} CI, 1.30 - 16.94; p=0.018) were significant predictors of SSI occurrence. CONCLUSION: Patients with Class II obesity and patients who undergo multilevel osteotomy may be at a significantly increased risk of developing a SSI within 30 days after 3CO for spine deformity.",
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AU - Nasser, Rani

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AU - Kinon, Merritt D.

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N2 - AIM: To investigate risk factors for surgical site infection (SSI) after three-column osteotomy (3CO) for spinal deformity. MATERIAL and METHODS: The American College of Surgeons National Surgical Quality Improvement Program database (2012- 2014) was reviewed. We included adult patients who underwent 3CO and compared pertinent cases (SSI) to controls (no SSI) in terms of preoperative and operative characteristics. Patients with clean/contaminated, contaminated, and dirty/infected wounds were excluded. A stepwise multivariate regression was used to identify independent predictors of SSI, with results presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: There were 293 patients who underwent 3CO for spinal deformity, out of whom 15 (5.1%) developed a SSI during the 30- day follow-up period. Of the 15 patients with SSI, 10 underwent reoperation (66.7%) within 30 days. Compared to controls, patients in the SSI group were more likely to be obese (p=0.030), have a higher American Society of Anesthesiologists (ASA) physical status class (p=0.051) and be more likely to undergo multilevel 3CO (p=0.013). After controlling for obesity, bleeding disorder, deformity type, ASA class, preoperative anemia, and multilevel procedures, Class II obesity (OR 4.98; 95% CI, 1.24 - 19.94; p=0.023) and multilevel 3CO (OR 4.71; 95% CI, 1.30 - 16.94; p=0.018) were significant predictors of SSI occurrence. CONCLUSION: Patients with Class II obesity and patients who undergo multilevel osteotomy may be at a significantly increased risk of developing a SSI within 30 days after 3CO for spine deformity.

AB - AIM: To investigate risk factors for surgical site infection (SSI) after three-column osteotomy (3CO) for spinal deformity. MATERIAL and METHODS: The American College of Surgeons National Surgical Quality Improvement Program database (2012- 2014) was reviewed. We included adult patients who underwent 3CO and compared pertinent cases (SSI) to controls (no SSI) in terms of preoperative and operative characteristics. Patients with clean/contaminated, contaminated, and dirty/infected wounds were excluded. A stepwise multivariate regression was used to identify independent predictors of SSI, with results presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: There were 293 patients who underwent 3CO for spinal deformity, out of whom 15 (5.1%) developed a SSI during the 30- day follow-up period. Of the 15 patients with SSI, 10 underwent reoperation (66.7%) within 30 days. Compared to controls, patients in the SSI group were more likely to be obese (p=0.030), have a higher American Society of Anesthesiologists (ASA) physical status class (p=0.051) and be more likely to undergo multilevel 3CO (p=0.013). After controlling for obesity, bleeding disorder, deformity type, ASA class, preoperative anemia, and multilevel procedures, Class II obesity (OR 4.98; 95% CI, 1.24 - 19.94; p=0.023) and multilevel 3CO (OR 4.71; 95% CI, 1.30 - 16.94; p=0.018) were significant predictors of SSI occurrence. CONCLUSION: Patients with Class II obesity and patients who undergo multilevel osteotomy may be at a significantly increased risk of developing a SSI within 30 days after 3CO for spine deformity.

KW - National Surgical Quality Improvement Program

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KW - Three-column osteotomy

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