Preoperative Predictors of Spinal Infection within the National Surgical Quality Inpatient Database

Area of Science:

• Spinal Surgery
• Infectious Disease Epidemiology
• Patient Safety

Background:

• Surgical-site infections (SSIs) significantly increase patient morbidity, mortality, and healthcare costs.
• Limited large-scale data exist on patient-specific risk factors for SSIs in spinal surgery.

Purpose of the Study:

• To identify independent predictors of SSIs in patients undergoing spinal surgery.
• To inform strategies for reducing postoperative infection risk.

Main Methods:

• Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2006-2012).
• Analyzed data from 60,179 spinal operations.
• Performed univariate and multivariate analyses to identify SSI predictors.

Main Results:

• 1.84% of patients (1110/60,179) developed SSIs.
• Independent predictors included female sex, inpatient status, insulin-dependent diabetes, prolonged steroid use, low hematocrit, obesity (BMI > 30), wound class, ASA class, and operative duration.
• Infected patients experienced higher rates of sepsis, longer hospital stays, and more reoperations.

Conclusions:

• A large national database analysis identified numerous independent risk factors for SSIs following spinal surgery.
• Several identified risk factors are modifiable preoperatively, offering opportunities to mitigate infection risk.