Does surgical site infection affect patient-reported outcomes after spinal surgery? A multicenter cohort study

被引：1

作者：

Nakamoto, Hideki ^{[1
,2
]}

Nakajima, Koji ^{[1
,2
]}

Miyahara, Junya ^{[1
,2
]}

Kato, So ^{[1
,2
]}

Doi, Toru ^{[1
,2
]}

Taniguchi, Yuki ^{[1
,2
]}

Matsubayashi, Yoshitaka ^{[1
,2
]}

Nishizawa, Mitsuhiro ^{[2
,3
]}

Kawamura, Naohiro ^{[2
,3
]}

Kumanomido, Yudai ^{[2
,4
,5
]}

Higashikawa, Akiro ^{[2
,4
,5
]}

Sasaki, Katsuyuki ^{[2
,6
]}

Takeshita, Yujiro ^{[2
,6
]}

Fukushima, Masayoshi ^{[2
,7
]}

Iizuka, Masaaki ^{[1
,2
,8
]}

Ono, Takashi ^{[2
,8
]}

Yu, Jim ^{[2
,9
]}

Hara, Nobuhiro ^{[2
,9
]}

Okamoto, Naoki ^{[2
,10
]}

Azuma, Seiichi ^{[2
,10
]}

Inanami, Hirohiko ^{[2
,11
]}

Sakamoto, Ryuji ^{[2
,11
]}

Tanaka, Sakae ^{[1
,2
]}

Oshima, Yasushi ^{[1
,2
]}

机构：

[1] Univ Tokyo, Fac Med, Dept Orthopaed Surg, 7-3-1 Hongo,Bunkyo Ku, Tokyo 1138655, Japan

[2] Univ Tokyo Spine Grp UTSG, 7-3-1 Hongo,Bunkyo Ku, Tokyo 1138655, Japan

[3] Japanese Red Cross Med Ctr, Dept Spine & Orthoped Surg, 4-2 Hiroo,Shibuya Ku, Tokyo 1508935, Japan

[4] Japan Org Occupat Hlth, Dept Orthopaed Surg, 1-1 Kizukisumiyoshi Cho,Nakahaha Ku, Kanagawa, Kanagawa 2118510, Japan

[5] Safety Kanto Rosai Hosp, 1-1 Kizukisumiyoshi Cho,Nakahaha Ku, Kanagawa, Kanagawa 2118510, Japan

[6] Yokohama Rosai Hosp, Dept Orthopaed Surg, Japan Org Occupat Hlth & Safety, 3211 Kozukue Cho,Kohoku Ku, Yokohama, Kanagawa 2220036, Japan

[7] Toranomon Gen Hosp, Dept Spine Ctr, 2-2-2 Minato Ku, Tokyo 1058470, Japan

[8] Japan Community Hlth care Org Tokyo, Dept Spinal Surg, Shinjuku Med Ctr, 5-1 Tsukudo Cho,Shinjuku Ku, Tokyo 1628543, Japan

[9] Japanese Red Cross Musashino Hosp, Dept Orthopaed Surg, 1-26-1 Kyonancho, Musashino, Tokyo 1800023, Japan

[10] Japanese Red Cross Saitama Hosp, Dept Orthopaed Surg, 1-5,Shintoshin,Chuo Ku, Saitama, Saitama 3308553, Japan

[11] Inanami Spine & Joint Hosp, Dept Orthopaed Surg, 3-17-5 Higashishinagawa,Shinagawa Ku, Tokyo 1400002, Japan

来源：

JOURNAL OF ORTHOPAEDIC SCIENCE | 2024年 / 29卷 / 06期

关键词：

Surgical site infection; Patient-reported outcome measures; Postoperative pain; Spine surgery; Propensity score; Multicenter cohort study; DEEP WOUND-INFECTION; RISK-FACTORS; COMPLICATIONS; FUSION; DECOMPRESSION; SCOLIOSIS; IMPACT;

D O I：

10.1016/j.jos.2023.10.010

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Surgical site infections are common in spinal surgeries. It is uncertain whether outcomes in spine surgery patients with vs. without surgical site infection are equivalent. Therefore, we assessed the effects of surgical site infection on postoperative patient-reported outcomes. Methods: We enrolled patients who underwent elective spine surgery at 12 hospitals between April 2017 and February 2020. We collected data regarding the patients' backgrounds, operative factors, and incidence of surgical site infection. Data for patient-reported outcomes, namely numerical rating scale, Neck Disability Index/Oswestry Disability Index, EuroQol Five-Dimensional questionnaire, and 12-Item Short- Form Health Survey scores, were obtained preoperatively and 1 year postoperatively. We divided the patients into with and without surgical site infection groups. Multivariate logistic regression analyses were performed to identify the risk factors for surgical site infection. Using propensity score matching, we obtained matched surgical site infection-negative and-positive groups. Student's t-test was used for comparisons of continuous variables, and Pearson's chi-square test was used to compare categorical variables between the two matched groups and two unmatched groups. Results: We enrolled 8861 patients in this study; 74 (0.8 %) developed surgical site infections. Cervical spine surgery and American Society of Anesthesiologists physical status classification >= 3 were identified as risk factors; microendoscopy was identified as a protective factor. Using propensity score matching, we compared surgical site infection-positive and-negative groups (74 in each group). No significant difference was found in postoperative pain or dysesthesia of the lower back, buttock, leg, and plantar area between the groups. When comparing preoperative with postoperative pain and dysesthesia, statistically significant improvement was observed for both variables in both groups (p < 0.01 for all variables). No significant differences were observed in postoperative outcomes between the matched surgical site infection-positive and-negative groups. Conclusions: Patients with surgical site infections had comparable postoperative outcomes to those without surgical site infections. (c) 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

引用

页码：1370 / 1375

页数：6

共 29 条

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