The seasonality of postoperative infection in spine surgery Clinical article
The seasonality of postoperative infection in spine surgery Clinical article
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DOI：
10.3171/2012.10.spine12572
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发表时间：
2013-01-01
影响因子：
2.8
通讯作者：
Vaccaro, Alexander
中科院分区：
文献类型：
--
作者：
Gruskay, Jordan;Smith, Jeremy;Vaccaro, Alexander
物体。来自多个学科的研究发现，夏季月份、气温升高、湿度升高以及感染率增加都与此有关。“七月效应”是一种假设，即新学院工作人员在学年开始时缺乏经验，会导致伤口并发症的增加，这一假设也被考虑过。最后，夏季与创伤相关的住院人数的增加可能会导致术后感染的发生率增加。之前的两项研究显示，夏季几个月的围手术期脊柱伤口感染的结果喜忧参半。这项研究的目的是确定脊柱外科术后感染率在一年中有显著波动的月份和/或季节。基于感染率易受季节性因素影响的观点，作者假设脊柱感染在夏季几个月会增加。纳入标准为2005年1月至2009年12月期间同一三级转诊机构的所有脊柱外科病例；纳入8122例病例。有污染伤口或活动性感染的患者被排除在外。按月和按季统计感染率，并进行比较。从春季到夏季的季节变化来看，在季节性和月度性的基础上，感染率都出现了统计上的显著增长(p=0.03p=0.024)。从秋季到冬季，感染率在季节性基础上显著下降(p=0.04)。季节感染率夏季最高(4.1%)，春季最低(2.8%)(p=0.03)。在作者所在的机构，与冬季和春季相比，在夏季和秋季进行的脊柱手术与伤口感染的发生率显著相关。这些数据支持围术期脊柱感染率存在季节性影响，这可能是由于天气模式的季节性变化和工作人员的经验等因素造成的。(http://thejns.org/doi/abs/10.3171/2012.10.SPINE12572)
Object. Studies from many disciplines have found an association with the summer months, elevated temperature, humidity, and an increased rate of infection. The "July effect," a hypothesis that the inexperience of new house staff at the beginning of an academic year leads to an increase in wound complications, has also been considered. Finally, an increase in trauma-related admissions in the summer months is likely to result in an increased incidence of postoperative infections. Two previous studies revealed mixed results concerning perioperative spinal wound infections in the summer months. The purpose of this study was to determine the months and/or seasons of the year that display significant fluctuation of postoperative infection rate in spine surgery. Based on the idea that infection rates are susceptible to seasonal factors, the authors hypothesized that spinal infections would increase during the summer months.Methods. Inclusion criteria were all spine surgery cases at a single tertiary referral institution between January 2005 and December 2009; 8122 cases were included. Patients presenting with a contaminated wound or active infection were excluded. Infection rates were calculated on a monthly and seasonal basis and compared.Results. A statistically significant increase in the infection rate was present on both a seasonal and monthly basis (p = 0.03 and p = 0.024) when looking at the seasonal change from spring to summer. A significant decrease in the infection rate was seen on a seasonal basis during the change from fall to winter (p = 0.04). The seasonal rate of infection was highest in the summer (4.1%) and decreased to the lowest point in the spring (2.8%) (p = 0.03).Conclusions. At the authors' institution, spine surgeries performed during the summer and fall months were associated with a significantly higher incidence of wound infection compared with the winter and spring. These data support the existence of a seasonal effect on perioperative spinal infection rates, which may be explained by seasonal variation in weather patterns and house staff experience, among other factors. (http://thejns.org/doi/abs/10.3171/2012.10.SPINE12572)