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Risk factors for surgical site infection and urinary tract infection after spine surgery

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Abstract

Purpose

This study aimed to identify and compare risk factors for surgical site infection (SSI) and non-surgical site infections (non-SSIs), particularly urinary tract infection (UTI), after spine surgery.

Methods

We retrospectively reviewed 825 patients (median age 59.0 years (range 33–70 years); 442 males) who underwent spine surgery at Kagoshima University Hospital from January 2009 to December 2014. Patient parameters were compared using the Mann–Whitney U and Fisher’s exact tests. Risk factors associated with SSI and UTI were analyzed via the multiple logistic regression analysis. P < 0.05 was considered statistically significant.

Results

SSI occurred in 14 of 825 cases (1.7 %), and non-SSI occurred in 23 of 825 cases (2.8 %). Most non-SSIs were UTIs (20 of 23 cases, 87.0 %). In the 14 patients with SSI, UTI occurred before SSI onset in one patient, and after SSI onset in two patients. UTI onset before SSI was not a risk factor for SSI. Multiple logistic regression analysis indicated that common risk factors for SSI and UTI were operation time (P = 0.0019 and 0.0162, respectively) and ASA classification 3 (P = 0.0132 and 0.0356, respectively). The 1 week post-operative C-reactive protein (CRP) level was a risk factor for UTI (P = 0.0299), but not for SSI (P = 0.4996).

Conclusions

There was no relationship between SSI and symptomatic UTI after spine surgery. Risk factors for post-operative SSI and UTI were operative time and ASA classification 3; 1 week post-operative CRP was a risk factor for UTI only.

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Acknowledgments

The authors thank Dr. Fumito Tanabe and Dr. Hideki Kawamura for their contributions to the manuscript, and Ms. Ayano Komure, Ms. Rika Sakamoto, and Ms. Kana Maeda for their excellent assistance.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Hiroyuki Tominaga, Satoshi Nagano, Takuya Yamamoto & Setsuro Komiya

  2. The Near-Future Locomotor Organ Medicine Creation Course (Kusunoki Kai), Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Takao Setoguchi

  3. Medical Joint Materials, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Yasuhiro Ishidou

Authors
  1. Hiroyuki Tominaga
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  2. Takao Setoguchi
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  3. Yasuhiro Ishidou
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  4. Satoshi Nagano
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Correspondence to Hiroyuki Tominaga.

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Tominaga, H., Setoguchi, T., Ishidou, Y. et al. Risk factors for surgical site infection and urinary tract infection after spine surgery. Eur Spine J 25, 3908–3915 (2016). https://doi.org/10.1007/s00586-016-4674-2

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  • DOI: https://doi.org/10.1007/s00586-016-4674-2

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