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 .
Diabetes and Early Postoperative Outcomes Following Lumbar Fusion
Study Design . Retrospective cohort study using data from the Nationwide Inpatient Sample administrative data from 1988 through 2003 . Objective . To examine perioperative morbidity and mortality for patients with and without diabetes mellitus following lumbar spinal fusion . Summary of Background Data . Diabetes has been associated with worse outcomes in a variety of orthopedic procedures including spinal surgery . There is limited evidence that diabetic patients have more complications following lumbar fusion with little published data to support this conclusion . Methods . Data from 197,461 patients who underwent lumbar fusion were included . Over 11,000 patients ( 5.6 % ) with a postoperative diagnosis of diabetes mellitus were identified . Selected variables were used for comparison of patients with and without diabetes . Bivariate statistical analyses compared postoperative complication rates while multivariate statistics were used to determine likelihood of complications with diabetes . Results . Bivariate analysis demonstrated that diabetes was significantly associated with postoperative infection , need for transfusion , pneumonia , in-hospital mortality , and nonroutine discharge ( P ≤ 0.001 ) . Adjusted multivariate regression analyses , however , suggested no difference in mortality although infection , transfusion , and nonroutine discharge continued to be highly significant ( P ≤ 0.002 ) . Significantly higher inflation adjusted total charges were also present with patients with diabetes as well as increased lengths of stay ( P < 0.001 ) . Conclusion . This nationally representative study of in patients in the United States provides evidence that diabetes is associated with increased risk for postoperative complications , nonroutine discharge , increased total hospital charges , and length of stay following lumbar fusion . Prospect i ve studies to determine causality as well as the potential impact of diabetes control on these variables have not yet been done
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 .