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 .
Surgical Wound Infection Rates and Risk Factors in Spinal Fusion in a University Teaching Hospital in Madrid, Spain
Study Design . Prospect i ve cohort study . Objective . To study risk factors linked to spinal fusion surgical wound infection ( SWI ) incidence and compare the incidence with rates in Madrid Region , Spain and United States as a whole . Summary of Background Data . SWI is one of the complications posed by spinal surgery . Indeed , spinal surgery has a higher infection rate than do other orthopedic surgeries such as total hip or knee arthroplasty . The study of risk factors that are susceptible to be modified will enable both the incidence of SWI and , by extension , related morbidity , mortality , and costs to be reduced . Methods . All patients undergoing spinal fusion at a tertiary hospital from June 2011 to June 2014 were included .  Infection rate was calculated , and the association between risk factors and SWI incidence was assessed by reference to odds ratio ( OR ) with univariate and multivariate analysis . Results . The study population ( n = 892 ) had a SWI rate of 3.9 % . The st and ardized infection ratio of our hospital was 0.58 with respect to the Madrid Region , 0.76 with respect to Spain 's national rate and 2.05 with respect to the US NHSN/CDC . The multivariate analysis showed that predictive factors of SWI were diabetes mellitus ( OR 2.81 , 95 % confidence interval , CI : 1.18–6.72 , P < 0.05 ) , chronic obstructive pulmonary disease ( COPD ) ( OR 5.16 , 95 % CI : 2.04–13.08 , P < 0.05 ) , duration of surgery higher than the 75th percentile ( OR 5.39 , 95 % CI : 1.77–110.84 , P < 0.05 ) and dirty surgery ( OR 14.01 , 95 % CI : 1.01–28.88 , P < 0.05 ) . Conclusion . Independent risk factors for SWI in spinal fusion are existence of diabetes mellitus , COPD , duration of surgery higher than the 75th percentile and dirty surgery . Knowing these risk factors enables action to be taken to reduce the SWI rate . 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 .