The Effect of Postoperative Spinal Infections on Patient Mortality
The Effect of Postoperative Spinal Infections on Patient Mortality
复制标题
DOI：
10.1097/brs.0000000000002277
复制
发表时间：
2018-02-01
期刊：
影响因子：
3
通讯作者：
Kepler, Christopher K.
中科院分区：
文献类型：
--
作者：
Casper, David S.;Zmistowski, Benjamin;Kepler, Christopher K.
研究设计。回顾性、匹配队列研究。目的。本研究旨在调查手术部位感染 (SSI) 与死亡率之间的关联，并确定预测 SSI 患者死亡率的任何因素。背景数据摘要。尽管为缓解做出了巨大努力，但 SSI，包括深度感染，仍然是脊柱手术后的常见并发症。相当大的发病率可能与感染有关，包括再入院、翻修手术和延迟康复。然而，尚不清楚发病率的增加是否与死亡率的增加有关。方法。以回顾性方式确定 2005 年至 2013 年期间择期脊柱手术后因 SSI 需要再次手术的单一中心患者。然后将这些患者与接受选择性脊柱手术但未发生 SSI 的患者进行一对三匹配。患者的年龄、性别、体重指数 (BMI)、查尔森合并症指数、手术年份、脊柱区域和入路进行匹配。社会保障死亡指数用于识别已故患者及其死亡时间。然后利用单变量统计数据来比较两组之间的死亡率。此外，还对 SSI 队列进行了 SSI 后死亡率预测因素的评估。结果。195 名患者在首次手术后平均 27.4 天（范围：1-467）发生 SSI。 90天、1年、2年和5年死亡率分别为1.54% vs 1.03% (P=0.70)、4.62% vs 1.2% (P=0.006)、7.73% vs 2.25% (P=0.001)、15.45% vs 3.43% (P=0.0002)。分别是 SSI 与对照患者。 SSI 队列中 2 年死亡率的预测因素是年龄增加 (P=0.02) 和查尔森合并症指数增加 (P=0.02)
Study Design.A retrospective, matched cohort study.Objectives.This study aims to investigate the association between surgical site infection (SSI) and mortality and ascertain any factors that predict mortality in those diagnosed with SSI.Summary of Background Data.Despite significant efforts toward mitigation, SSI, including deep infection, remains a common complication following spine surgery, Considerable morbidity may be associated with infection, including hospital readmission, revision surgery, and delayed rehabilitation. However, it is not known whether this increase in morbidity is associated with increased mortality.Methods.Patients from a single center requiring reoperation for SSI following elective spine surgery between 2005 and 2013 were identified in a retrospective fashion. These patients were then matched one-to-three with patients undergoing elective spine surgery without SSI. Patients were matched for age, gender, body mass index (BMI), Charlson comorbidity index, year of surgery, spine region, and approach. The Social Security Death Index was utilized to identify deceased patients and their time of death. Univariate statistics were then utilized to compare mortality rates between the two groups. In addition, the SSI cohort was evaluated for predictors of mortality following SSI.Results.One-hundred ninety-five patients developed SSI at a mean of 27.4 (range: 1-467) days from the index surgery. Ninety-day, 1-year, 2-year, and 5-year mortality rates were 1.54% versus 1.03% (P=0.70), 4.62% versus 1.2% (P=0.006), 7.73% versus 2.25% (P=0.001), and 15.45% versus 3.43% (P=0.0002) for SSI versus control patients, respectively. Predictors of 2-year mortality in the SSI cohort were increased age (P=0.02) and increased Charlson Comorbidity Index (P