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 .
Predictors of Hospital Readmission and Surgical Site Infection in the United States, Denmark, and Japan: Is Risk Stratification a Universal Language?
Study Design . Retrospective review of three spine surgery data bases . Objectives . The purpose of the present study is to determine whether predictors of  hospital readmission and surgical site infection ( SSI )  after lumbar fusion will be the same in United States , Denmark , and Japan . Summary of Background Data . Because clinical decision making becomes more data driven , risk stratification will be crucial to minimize complications . Spine surgeons worldwide face this issue , leading to parallel efforts to address risk stratification . This raises the question as to whether pooled data would be valuable and whether models generated in one country would be applicable to other population s. Methods . Predictors of SSI and 30-day readmission from three prospect i ve data bases ( National Neurosurgery Quality and Outcomes Data base [ N2QOD ] N = 2653 , DaneSpine N = 1993 , Japan Multicenter Spine Data base [ JAMSD ] N = 3798 ) were determined and compared to identify common or divergent predictive risks . Results . Predictive variables differed in the three data bases , for both readmission and SSI . Factors predictive for hospital readmission were American Society of Anesthesiologists ( ASA ) grade in N2QOD ( P = 0.013 , odds ratio [ OR ] 2.08 ) , fusion levels in DaneSpine ( P = 0.005 , OR 1.67 ) , and sex in JAMSD ( P = 0.001 , OR = 2.81 ) . Associated differences in demographics and procedural factors included mean ASA grade ( N2QOD = 2.45 , JAMSD = 1.72 ) and fusion levels ( N2QOD = 1.39 , DaneSpine = 1.52 , JAMSD = 1.34 ) . For SSI , sex ( P = 0.000 , OR = 3.30 ) , diabetes ( P = 0.000 , OR = 2.90 ) , and length of stay ( P = 0.000 , OR = 1.02 ) were predictive in JAMSD . No predictors were identified in N2QOD or DaneSpine . Conclusion . Predictors of SSI and hospital readmission differ in the United States , Denmark , and Japan , suggesting that risk stratification models may need to be population specific or adjusted . Some differences in measured parameters exist in the three data bases analyzed ; however , patient and procedure selection also appear to differ and may limit the ability to directly pool data from different regions . Therefore , risk stratification models developed in one country may not be directly applicable to other countries . 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 .