Risk factors for surgical site infection after posterior fixation surgery and intraoperative radiotherapy for spinal metastases.
Risk factors for surgical site infection after posterior fixation surgery and intraoperative radiotherapy for spinal metastases.
复制标题
脊柱转移瘤后路固定手术及术中放疗后手术部位感染的危险因素。
DOI：
10.1007/s00586-015-4116-6
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Kondo T.
中科院分区：
文献类型：
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作者：
Sugita S;Hozumi T;Yamakawa K;Goto T;Kondo T.
目的：后路手术结合术中放射治疗脊柱转移瘤是一种有效的治疗方法。然而，该手术涉及从手术室转移到放射治疗室，并且由于这些患者在某种程度上免疫功能低下，术后手术部位感染（SSI）的风险可能会增加。我们的研究的目的是确定风险因素和患者的特点与术后SSI后固定手术和术中放疗脊柱transferas.MethodsParticipants包括279例谁接受IORT治疗脊柱转移瘤2004年8月至2013年6月。术后1个月内发生SSI的患者被归类为感染，所有其他患者被归类为非感染。我们比较了年龄、性别、术前皮质类固醇的使用、糖尿病病史、预后评分等因素（Tomita、Tokuhashi和Katagiri）、术前和术后Frankel量表评分、肿瘤起源部位、术前放疗给药、手术时间、术中失血量、术中照射剂量，结果41例患者（14.7%）发生了SSI。Katagiri和Tokuhashi的预后评分（P< 0.05）、术后Frankel评分（P< 0.01）、术前放疗（P< 0.05）和术后体力状态（P< 0.05）均与SSI的发生显著相关。多因素分析显示术前放疗是SSI的独立相关因素（P< 0.05）。结论预后、术后步行功能、术前放疗是脊柱转移瘤SSI的危险因素。手术持续时间和术中失血量与SSI的发生无关。
PurposePosterior surgery with intraoperative radiotherapy for spinal metastases offers effective therapy, as we have reported previously. However, the procedure involves transfer from the operating room to the radiotherapy room, and as these patients are somewhat immunocompromised, the risk of postoperative surgical site infection (SSI) may be increased. The aim of our study was to identify risk factors and patient characteristics associated with postoperative SSI following posterior fixation surgery and intraoperative radiotherapy for spinal metastases.MethodsParticipants comprised 279 patients who underwent IORT for the treatment of spinal metastases between August 2004 and June 2013. Patients who suffered SSI within 1 month after surgery were categorized as infected, and all others were categorized as non-infected. We compared factors of age, sex, use of pre-operative corticosteroid, medical history of diabetes, prognosis scores (Tomita, Tokuhashi, and Katagiri), pre- and postoperative Frankel scale scores, site of tumor origin, administration of pre-operative radiotherapy, operation time, intraoperative blood loss, intraoperative irradiation dose, and pre- and postoperative performance status between groups.ResultsSSI occurred in 41 patients (14.7 %). Katagiri’s and Tokuhashi’s prognostic scores (P< 0.05 each), postoperative Frankel scale score (P< 0.01), administration of pre-operative radiotherapy (P< 0.05), and postoperative performance status (P< 0.05) all correlated significantly with occurrence of SSI. Multivariate analysis using those factors revealed administration of pre-operative radiotherapy as a factor independently associated with SSI (P< 0.05).ConclusionsPatient prognosis, postoperative ambulatory function, and pre-operative radiotherapy were risk factors for SSI in patients with spinal metastases. Duration of surgery and intraoperative blood loss were not associated with occurrence of SSI.