Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases.

Brief review

이 논문은 퇴행성 척추질환 때문에 후방경유 요추 유합술을 받은 817명의 환자에게 나타난 감염률과 감염에 영향을 끼치는 요소들을 연구한 논문 입니다.

후향적으로 환자의 데이터를 검토하여 감염률을 조사했고, 단계적 다변량 비례 위험 회귀분석법을 통하여 요추감염과 연관성이 있는 요소들을 알아냈습니다.

연구대상인 817명의 환자에 대해서는 감염률이 4.5%로 나타났고,  나이, 당뇨지수, 비만도, 이전에 척추수술을 시행했는지의 여부, 재원기간 등의 요소들이 감염에 영향을 끼치는 것으로 나타났습니다.

*Title: Risk of infection following posterior instrumented lumbar fusion for degenerative spine disease in 817 consecutive cases.

퇴행성 척추질환으로 후방경유 요추 유합술을 시행한 817명의 사례에 대한 감염의 위험성

*Author: Kaisorn L. Chaichana, Mohamad Bydon, David R. Santiago-Dieppa, Lee Hwang, Gregory McLoughlin, Daniel M. Sciubb a, Jean-Paul Wolinsky, Ali Bydon, Ziya L. Gokaslan, Timothy Witham

*Bibliography: J Neurosurg Spine. 2013 Nov 8. [Epub aheadof print]

Object

The rate and factors of infection risk remains unclear for Posterior lumbar spinal fusion (for degenerative spine disease)

Purpose: To ascertain the incidence and factors of postoperative spinal infections.

Methods

▶Period: 1993 ~ 2010

▶Subject: 817 patients who underwent posterior lumbar fusion for degenerative disease.

-Retrospectively data reviewed.

-To identify the infection factors, using Stepwise multivariate proportional hazards regression analysis.

Results

1. Infection rate: 4.5%

(37 patients out of 817 patients developed postoperative spine infection at a median of 0.6 months (IQR 0.3-0.9) ).

2. Infection factors

1. age (RR 1.004 [95% CI 1.001-1.009], p = 0.049)

2. diabetes (RR 5.583 [95% CI 1.322-19.737], p = 0.02)

3. obesity (RR 6.216 [95% CI 1.832-9.338], p = 0.005)

4. previous spine surgery (RR 2.994 [95% CI 1.263-9.346], p = 0.009)

5. duration of hospital stay (RR 1.155 [95% CI 1.076-1.230], p = 0.003).

Conclusions

-Several factors were associated with an risk of infection among patients underwent lumbar fusion for degenerative disease. (factors: older age, diabetes, obesity, prior spine surgery, and length of hospital stay)