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 .
The Impact of Current Smoking and Smoking Cessation on Short-Term Morbidity Risk After Lumbar Spine Surgery
Study Design . A retrospective review of prospect ively collected data . Objective . The aim of this study was to determine the impact of current smoking or prior smoking cessation on 30-day morbidity risk following lumbar spine surgery . Summary of Background Data . Prior studies have reported conflicting data regarding the impact of smoking on morbidity risk , and few studies have investigated smoking cessation . Methods . A large , multicenter , prospect ively collected clinical registry was queried for all adult patients undergoing lumbar spine surgery in 2012 and 2013 , and 35,477 cases were identified .  Morbidity data are collected by on-site clinical personnel for 30 days postoperatively . Patients were divided into categories of “ never-smoker , ” for patients with no reported cigarette use ( n = 27,246 ) , “ former smoker , ” for patients who quit smoking more than 12 months before surgery ( n = 562 ) , and “ current smoker , ” for patients still using cigarettes ( n = 7669 ) . A univariate analysis was conducted to identify un-adjusted differences in morbidity risk , and a multivariate analysis was conducted in an attempt to control for confounders . Results . In the multivariate analysis , current smokers had a significantly higher risk of both superficial surgical site infection and overall wound complications , than never-smokers ( P < 0.05 for each ) . Current smokers also had a significantly higher risk of total 30-day morbidity ( P = 0.04 ) . There was a trend toward former smokers also having an increased risk , but this did not reach significance in any category . Patients with a pack-year smoking history of 1 to 20 pack-years and more than 40 pack-years both had a significantly higher risk of superficial surgical site infections ( P < 0.05 for each ) . Conclusion . Current smoking is associated with a small but significant increase in systemic morbidity and wound complications following elective lumbar spine procedures . Increasing pack year history was also associated with wound complication risk , suggesting a dose-related effect . The data provide preliminary support for future studies on smoking cessation . Level of Evidence :
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 .