Risk Factors For Surgical Site Infection Following Orthopaedic Spinal Operations

Objective: Surgical site infections are not uncommon following spinal operations, the position is near by nervous system, and they can be associated with serious morbidity, mortality, and increased resource utilization. The accurate identification of risk factors is essential to develop strategies to prevent these potentially devastating infections. We conducted a case-control study to determine independent risk factors for surgical site infection following orthopaedic spinal operations.Methods: We performed a retrospective case-control study of patients who had had an orthopaedic spinal operation performed at a university-affiliated hospital from 2004 to 2009. Thrity-two patients with surgical site infection were identified and compared with 132 uninfected control patients. Risk factors for surgical site infection were determined with univariate analyses and multivariate logistic regression.Results: The overall rate of spinal surgical site infection during the five years of the study was 2.3% (Thrity-two of 1390).Univariate analyses showed suboptimal timing of prophylactic antibiotic therapy,diabetes,leakage of cerebrospinal fluid,Preoperative or postoperative incontinence,extended preoperative hospitalization,operating times,operating extent,ICU,to be significantly higher in patients in whom surgical site infection developed than in uninfected control patients.Independent risk factors for surgical site infection that were identified by multivariate analysis were suboptimal timing of prophylactic antibiotic therapy(OR=8.181,95% confidence interval =2.364,28.313),diabetes(OR=5.558,95% confidence interval =1.032,29.922),leakage of cerebrospinal fluid(OR=5.197,95% confidence interval =1.288,20.966).Conclusion: Independent risk factors for surgical site infection that were suboptimal timing of prophylactic antibiotic therapy,diabetes,leakage of cerebrospinal fluid.