Analysis of risk factors for surgical site infection after posterior lumbar internal fixation

English Keywords:Posterior lumbar internal fixation  Surgical site infection  Risk factors

English Abstract:

  【Abstract】 Objectives: To explore the risk factors of surgical site infection after posterior lumbar internal fixation, and to provide reference for reducing the incidence of surgical site infection. Methods: The study reviewed the data of 1073 cases of patients who accepted posterior lumbar internal fixation in our department from January 1, 2016 to December 31, 2018, including 516 males and 557 females, aged 18－84 years (54.67±13.23 years). Infected patients were included in the infection group and the rest were included in the non-infection group. Data such as gender, age, diagnosis, Body mass index(BMI), diabetes, hypertension, duration of operation, blood loss, transfusion, smoking history, American Society of Anesthesiologists(ASA) classification, preoperative steroid use, internal fixation levels, whether fixed on sacrum or pelvis, whether revision operation, starting time of operation were collected for univariate analysis. The positive results were analyzed by multivariate Logistic regression analysis, and the risk factors of infection were identified. Results: Among all patients, 19 cases of surgical site infection occurred, including 11 males and 8 females, aged 18－77 years(54.89±16.67 years), with an infection rate of 1.77%(19/1073). Univariate analysis showed that there were significant differences between the two groups in obesity(BMI≥28kg/m2), diabetes, duration of operation, and starting time of operation(P＜0.05). There were no significant differences in gender, age, diagnosis, hypertension, blood loss, transfusion, smoking history, ASA classification, preoperative steroid use, internal fixation levels, whether fixed on sacrum or pelvis, and whether revision operation(P＞0.05). Multivariate Logistic regression analysis showed that there were statistically significant differences in obesity(OR=6.704, P=0.005), history of diabetes(OR=4.071, P=0.008), long operation time(OR=7.102, P=0.000) and operation starting time at night(OR=3.981, P=0.018). Conclusions: Obesity, diabetes history, long operation duration time and operation starts at night are independent risk factors of surgical site infection after posterior lumbar internal fixation, and targeted preventive measures should be taken to reduce the incidence of postoperative infection.