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Risk Factors for Early Infection in Pediatric Spinal Deformity Surgery: A Multivariate Analysis

Jerry Y Du1, Connie Poe-Kochert1, George H Thompson1

  • 1Division of Pediatric Orthopaedics, Rainbow Babies & Children's Hospitals/University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA.

Spine Deformity
|May 5, 2019
PubMed

Insights

Nonidiopathic scoliosis and increased intraoperative crystalloid fluids are key risk factors for early deep surgical site infections (SSIs) after pediatric spinal fusion surgery. Understanding these factors can help reduce infection rates in children undergoing spinal deformity correction.

Area of Science:

  • Pediatric Orthopedics
  • Surgical Site Infections
  • Spinal Surgery

Background:

  • Deep surgical site infections (SSIs) are a significant complication following pediatric spinal deformity surgery.
  • Early SSIs (within three months) can lead to considerable patient morbidity.

Purpose of the Study:

  • To identify independent risk factors for early deep SSIs after primary, single-stage pediatric posterior spinal fusion and instrumentation (PSFI).

Main Methods:

  • Retrospective case-control study of 616 patients undergoing PSFI between 2001 and 2016.
  • Multivariate analysis of demographics, comorbidities, and perioperative factors to identify independent risk factors for early deep SSI.

Main Results:

  • Eleven patients (1.6%) developed early deep SSIs.
  • Independent risk factors identified were nonidiopathic scoliosis etiologies (OR: 8.384) and increased intraoperative crystalloid administration (OR: 1.547 per liter).
  • Mean crystalloid volume was significantly higher in the SSI group (3.3 L) compared to the noninfected group (2.4 L).

Conclusions:

  • Nonidiopathic scoliosis and the amount of intraoperative crystalloids are independently associated with early postoperative SSIs.
  • Further research into intraoperative fluid management may reveal modifiable strategies to decrease SSI risk in pediatric spinal fusion patients.
Abstract

Keywords:
AnesthesiologyCrystalloidInfectionPediatric scoliosisRisk factor

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