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 .
Risk factors for surgical site infection in elective routine degenerative lumbar surgeries.
BACKGROUND CONTEXT Surgical site infection ( SSI ) is one of the most serious complications of spine surgery . Its predisposing factors , especially in routine surgeries , are less reported . However , a number of patient- and procedure-related risk factors could be avoided or at least determined preoperatively . Moreover , the patient-specific risk for SSI could be estimated before the elective surgery . PURPOSE The aim of the present study was to analyze the preoperatively determinable risk factors for SSI in patients who require elective routine surgery related to lumbar disc degeneration and to build a multivariable model for the individual risk prediction . STUDY DESIGN Analysis of prospect ively collected st and ardized clinical data and the validation of the results on an independent prospect i ve cohort were performed . PATIENT SAMPLE One thous and thirty ( N=1,030 ) patients were included in the study . All subjects underwent primary lumbar single- or two-level decompression , microdiscectomy , or instrumented fusion .  OUTCOME MEASURES Occurrence of an SSI defined according to the current Centers for Disease Control and Prevention guidelines that required surgical or nonsurgical therapy . METHODS The effect of preoperative patient characteristics , comorbidities , disease history , and invasiveness of the elective surgery on the risk of SSI was determined in uni- and multivariate logistic regression models in the test cohort ( N=723 ) . The performance of the final multivariable regression model was assessed by measuring its discriminative ability ( c-index ) in receiver operating characteristic analysis . Performance of the multivariable risk estimation model was tested on the validation ( N=307 ) cohort . RESULTS The prevalence of SSI was 3.5 % and 3.9 % in the test and in the validation cohorts , respectively . The final multivariable regression model predictive ( p=.003 ) for SSI contained the patient 's age , body mass index ( BMI ) , and the presence of 5 comorbidities , such as diabetes , ischemic heart disease , arrhythmia , chronic liver disease , and autoimmune disease as risk factors . The c-index of the model was 0.71 , showing good discriminative ability , and it was confirmed by the data of the independent validation cohort ( c=0.72 ) . CONCLUSIONS Predisposing factors for SSI were older age , higher BMI , and the presence of certain comorbidities in the present study . The cumulative number of risk factors significantly associated with the increasing risk for an SSI ( p<.0001 ) . Our model needs further validation but it may be used for individual risk assessment and reduction in the future
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 .