Analysis of related influencing factors of postoperative surgical infection in patients with spinal tuberculosis

English Keywords:Spinal tuberculosis  Postoperative infection  Risk factors

English Abstract:

  【Abstract】 Objectives: To explore the risk factors of postoperative infection of spinal tuberculosis, summarize the preventive measures, and provide reference for clinical treatment. Methods: A retrospective analysis of risk factors was performed on 161 patients with spinal tuberculosis who received surgical treatment in our hospital from January 2018 to January 2020. Information related to patient factors was collected, including: Whether age>60, gender, serum albumin concentration<30g/L, blood sedimentation≥20mm/h, or BMI<18.5kg/m2, diabetes, blood sugar levels>11.1mmol/L 72h after peak, and smoking history, spinal cord injury, lesion position(neck, chest, chest and waist section or lumbar segment) and scope(lesions was less than 3 segments), convex deformities, and cold abscess. Surgery related factors included: usage of pulsed rinsing gun, implants filled, anterior column reconstruction, operative time less than 300 minutes, intraoperative blood transfusion, local use of intraoperative streptomycin, and surgical approach. SPSS 23.0 software was used for statistical analysis, and non-conditional Logistic regression was used for multi-factor analysis. Results: Single factor analysis showed that low serum protein concentration(<30g/L)(rate 16.7%), blood sedimentation 20mm/h(infection rate 14.0%), or higher BMI<18.5kg/m2(infection rate 16.7%), diabetes(infection rate 15.2%), peak blood sugar or greater tendency for 11.1mmol/L(infection rate 24%), merging, and cold abscess(infection rate 3.03%), and other related factors in patients with spinal tuberculosis were the risk factors for postoperative surgical site infection(P<0.05). Among surgical factors, long operation time(≥300min)(infection rate: 12.7%), intraoperative blood transfusion(infection rate: 10.9%), and local absence of streptomycin(infection rate: 15.8%) were risk factors for postoperative surgical site infection of spinal tuberculosis(P<0.05). Age, sex, smoking history, spinal cord injury, lesion position and scope, or presence of kyphosis were not risk factors for surgical site infection(P>0.05). In addition, use of pulse washing gun, filled implants, anterior column reconstruction, and surgical approach were not risk factors either(P>0.05). Conclusions: Before spinal tuberculosis, the nutritional status of the patients should be adjusted as much as possible, and the blood glucose should be actively controlled. The application of streptomycin to the infected lesions in the operative area and the thorough removal of cold abscess lesions should be regarded as the key points for the prevention of postoperative infection in these patients.