The Analysis Of Risk Factors Of Early Surgical Site Infection Complications After Posterior Lumbar Interbody Fusion And Clinical Indicators

Objective:By analyzing the associated risk factors of early surgical site infection(SSI)in patients undergoing posterior lumbar interbody fusion(PLIF),and comparing the changes of related serum inflammation index in patients between preoperatively and postoperatively,to explore the high risk factors of early postoperative surgical site infection,and provide references for reduce the incidence of postoperative SSI.Methods and Materials:This article analyzes retrospectively 255 cases of posterior lumbar interbody fusion(PLIF)in the second affiliated hospital of Nanjing medical university from January 2014 to January 2017.We collected the clinical data of patients including age,gender,smoking history,diabetes,operation time,estimated blood loss,the time of drainage tube placement,and then divided them into infection group(group A)and non infection group(group B)according to the results of postoperative blood culture.The comparison was performed in team of white cell count(WBC),the percent of neutrophile granulocyte(NEU%),hyper-sensitive C-reactive protein(hs-CRP),Erythrocyte sedimentation rate(ESR),and procalcitonin(PCT)between two groups.Results:The overall rate of early SSI was 3.5%(9/255).The infection rate increased significantly in patients with these bellowing characters:such as age 60 and older,have smoking history,complicated with diabetes,operation time more than 180 min,and blood loss over 300ml(p<0.05).There were no significant difference on gender and drain time of the two groups(p>0.05).The age,smoking history,history of diabetes,time of operation,intraoperative blood loss were analyzed with multivariate analysis by non-conditional Logistic regression analysis.The results show that smoking history,history of diabetes,time of operation are independent risk factors of PLIF(p<0.05).In contrast,age and intraoperative blood loss have little to do with PLIF(p>0.05).The level of the indexes(WBC,NUE%,ESR,CRP,and PCT)of the infection group were higher after the surgery for 1,3,and 7than before the surgery((p>0.05).Conclusion:The retrospective analysis shows that smoking history,history of diabetes,time of operation are independent risk factors of PLIF.The level of the WBC,NUE%,ESR,CRP,and PCT of the infection group were higher after the surgery than before the surgery.The clinicians should focus primarily on these high risk groups,and closely monitor as well as comprehensive analysis the clinical correlation index,to improve the early diagnostic rate and early infectious.