Elevated Risk of Infections after Spinal Cord Surgery in Relation to Preoperative Pressure Ulcers: a Follow-up Study

Factors associated with infections after spinal cord surgery were not fully understood. This study aimed to evaluate whether preoperative pressure ulcers was a risk factor of infections after spinal cord operation. A 1:1 matched follow-up study was performed in a tertiary referral center in southwest China between 2010 and 2015. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression analysis. A total of 334 patients with spinal cord surgery were recruited (167 patients with preoperative pressure ulcers and 167 patients without preoperative pressure ulcers). Participants previously exposed to pressure ulcers had an elevated risk of infections post spinal cord operation including surgical site infection (RR: 2.3, 95% CI: 1.1, 4.7), pneumonia (RR: 2.4, 95% CI: 1.1,5.3), urinary tract infection (RR: 2.8, 95% CI: 1.1, 7.3), any kinds of postoperative infections (RR: 3.4, 95% CI: 2.1, 5.6) and 30-day postoperative hospitalization for infections (RR: 2.6, 95% CI: 1.1, 6.0). The associations between preoperative pressure ulcers in stage III to IV and postoperative infections were also pronounced, but towards null in stage I to II. The study showed an increased risk of infections after spinal cord surgery in patients with preoperative pressure ulcers, indicative of an urgent need for monitoring postoperative infections and medical treatment for patients with pressure sores.