Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .
Development of an Index to Characterize the “Invasiveness” of Spine Surgery: Validation by Comparison to Blood Loss and Operative Time
Study Design . Prospect i ve cohort study . Objective . To create and vali date an index describing the extent of spine surgical intervention to allow fair comparisons of complication rates among patients treated by different surgeons , devices , or hospitals . Summary of Background Data . Safety comparisons in spine surgery are limited by lack of methods that adjust for important variations in the surgical “ case-mix . ” Among other factors , the magnitude of an operation is likely to have a substantial influence on the likelihood of complications . Methods . We created a spine surgery invasiveness index defined as the sum , across all vertebral levels , of 6 possible interventions on each operated vertebra : anterior decompression , anterior fusion , anterior instrumentation , posterior decompression , posterior fusion , and posterior instrumentation . We assessed the validity of this index by examining its association with blood loss and surgery duration in 1723 spine surgeries , adjusting for important factors including age , gender , body mass index , diagnosis , neurologic deficit , revision surgery , and vertebral level of surgery . Results . Blood loss increased by 11.5 % and surgery duration increased by 12.8 minutes for each unit increase in the invasiveness index . The invasiveness index explained 44 % of the variation in blood loss and 52 % of the variation in surgery duration . For specific surgical components , blood loss increased by 9.4 % and surgery duration by 11.4 minutes for each vertebral level of anterior decompression , 19.4 % and 33.8 minutes for each segment of anterior instrumentation , 12.9 % and 22.7 minutes for each level of posterior decompression , and 25.1 % and 18.8 minutes for each segment of posterior instrumentation . Conclusion . An “ invasiveness ” index based on the number of vertebrae decompressed , fused , or instrumented showed the expected associations with both blood loss and surgery duration . This quantitative description of surgery invasiveness may be useful to adjust for surgical variations when making safety comparisons in spine surgery
Surgical associated factors — preoperative radiation/postoperative blood transfusion , combined anterior/posterior approach , surgical invasiveness , or levels of instrumentation were associated with increased SSI .
There is mixed evidence of age , duration of surgery , surgical team , intraoperative blood loss , dural tear , and urinary tract infection/urinary catheter in association with SSI .
Conclusion : SSIs are associated with many risk factors that can be patient or surgically related .
Objective : To perform a review of SSI risk factors and more specifically , categorize them into patient and surgical factors .