Risk factors for wound infection in surgery for spinal metastasis

Siva Kumar, Dmitri Van Popta, R. Rodrigues-Pinto, J. Stephenson, Saeed Mohammad, Irfan Siddique, Rajat Verma

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Wound infection rates are generally higher in patients undergoing surgery for spinal metastasis. Risk factors of wound infection in these patients are poorly understood.Purpose: To identify demographic and clinical variables that may be associated with patients experiencing a higher wound infection rate.Study design: Retrospective study with prospectively collected data of spinal metastasis patients operated consecutively at a University Teaching Hospital, adult spine division which is a tertiary referral centre for complex spinal surgery.Patient sample: Ninety-eight patients were all surgically treated, consecutively from January 2009 to September 2011. Three patients had to be excluded due to inadequate data.Outcome measures: Physiological measures, with presence or absence of microbiologically proven infection.Methods: Various demographic and clinical data were recorded, including age, serum albumin level, blood total lymphocyte count, corticosteroid intake, Malnutrition Universal Screening Tool (MUST) score, neurological disability, skin closure material used, levels of surgery and administration of peri-operative corticosteroids. No funding was received from any sources for this study and as far as we are aware, there are no potential conflict of interest-associated biases in this study.Results: Higher probabilities of infection were associated with low albumin level, seven or more levels of surgery, use of delayed/non-absorbable skin closure material and presence of neurological disability. Of these factors, levels of surgery were found to be statistically significant at the 5 % significance level.Conclusion: Risk of infection is high (17.9 %) in patients undergoing surgery for spinal metastasis. Seven or more vertebral levels of surgery increase the risk of infection significantly (p < 0.05). Low albumin level and presence of neurological disability appear to show a trend towards increased risk of infection. Use of absorbable skin closure material, age, low lymphocyte count, peri-operative administration of corticosteroids and MUST score do not appear to influence the risk of infection.
Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalEuropean Spine Journal
Volume24
Issue number3
Early online date15 Dec 2013
DOIs
Publication statusPublished - Mar 2015

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Wound Infection
Neoplasm Metastasis
Infection
Adrenal Cortex Hormones
Lymphocyte Count
Malnutrition
Skin
Albumins
Demography
Conflict of Interest
Tertiary Care Centers
Serum Albumin
Teaching Hospitals
Spine
Retrospective Studies
Outcome Assessment (Health Care)

Cite this

Kumar, S., Van Popta, D., Rodrigues-Pinto, R., Stephenson, J., Mohammad, S., Siddique, I., & Verma, R. (2015). Risk factors for wound infection in surgery for spinal metastasis. European Spine Journal, 24(3), 528-532. https://doi.org/10.1007/s00586-013-3127-4
Kumar, Siva ; Van Popta, Dmitri ; Rodrigues-Pinto, R. ; Stephenson, J. ; Mohammad, Saeed ; Siddique, Irfan ; Verma, Rajat. / Risk factors for wound infection in surgery for spinal metastasis. In: European Spine Journal. 2015 ; Vol. 24, No. 3. pp. 528-532.
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abstract = "Wound infection rates are generally higher in patients undergoing surgery for spinal metastasis. Risk factors of wound infection in these patients are poorly understood.Purpose: To identify demographic and clinical variables that may be associated with patients experiencing a higher wound infection rate.Study design: Retrospective study with prospectively collected data of spinal metastasis patients operated consecutively at a University Teaching Hospital, adult spine division which is a tertiary referral centre for complex spinal surgery.Patient sample: Ninety-eight patients were all surgically treated, consecutively from January 2009 to September 2011. Three patients had to be excluded due to inadequate data.Outcome measures: Physiological measures, with presence or absence of microbiologically proven infection.Methods: Various demographic and clinical data were recorded, including age, serum albumin level, blood total lymphocyte count, corticosteroid intake, Malnutrition Universal Screening Tool (MUST) score, neurological disability, skin closure material used, levels of surgery and administration of peri-operative corticosteroids. No funding was received from any sources for this study and as far as we are aware, there are no potential conflict of interest-associated biases in this study.Results: Higher probabilities of infection were associated with low albumin level, seven or more levels of surgery, use of delayed/non-absorbable skin closure material and presence of neurological disability. Of these factors, levels of surgery were found to be statistically significant at the 5 {\%} significance level.Conclusion: Risk of infection is high (17.9 {\%}) in patients undergoing surgery for spinal metastasis. Seven or more vertebral levels of surgery increase the risk of infection significantly (p < 0.05). Low albumin level and presence of neurological disability appear to show a trend towards increased risk of infection. Use of absorbable skin closure material, age, low lymphocyte count, peri-operative administration of corticosteroids and MUST score do not appear to influence the risk of infection.",
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Kumar, S, Van Popta, D, Rodrigues-Pinto, R, Stephenson, J, Mohammad, S, Siddique, I & Verma, R 2015, 'Risk factors for wound infection in surgery for spinal metastasis', European Spine Journal, vol. 24, no. 3, pp. 528-532. https://doi.org/10.1007/s00586-013-3127-4

Risk factors for wound infection in surgery for spinal metastasis. / Kumar, Siva; Van Popta, Dmitri; Rodrigues-Pinto, R.; Stephenson, J.; Mohammad, Saeed; Siddique, Irfan; Verma, Rajat.

In: European Spine Journal, Vol. 24, No. 3, 03.2015, p. 528-532.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for wound infection in surgery for spinal metastasis

AU - Kumar, Siva

AU - Van Popta, Dmitri

AU - Rodrigues-Pinto, R.

AU - Stephenson, J.

AU - Mohammad, Saeed

AU - Siddique, Irfan

AU - Verma, Rajat

PY - 2015/3

Y1 - 2015/3

N2 - Wound infection rates are generally higher in patients undergoing surgery for spinal metastasis. Risk factors of wound infection in these patients are poorly understood.Purpose: To identify demographic and clinical variables that may be associated with patients experiencing a higher wound infection rate.Study design: Retrospective study with prospectively collected data of spinal metastasis patients operated consecutively at a University Teaching Hospital, adult spine division which is a tertiary referral centre for complex spinal surgery.Patient sample: Ninety-eight patients were all surgically treated, consecutively from January 2009 to September 2011. Three patients had to be excluded due to inadequate data.Outcome measures: Physiological measures, with presence or absence of microbiologically proven infection.Methods: Various demographic and clinical data were recorded, including age, serum albumin level, blood total lymphocyte count, corticosteroid intake, Malnutrition Universal Screening Tool (MUST) score, neurological disability, skin closure material used, levels of surgery and administration of peri-operative corticosteroids. No funding was received from any sources for this study and as far as we are aware, there are no potential conflict of interest-associated biases in this study.Results: Higher probabilities of infection were associated with low albumin level, seven or more levels of surgery, use of delayed/non-absorbable skin closure material and presence of neurological disability. Of these factors, levels of surgery were found to be statistically significant at the 5 % significance level.Conclusion: Risk of infection is high (17.9 %) in patients undergoing surgery for spinal metastasis. Seven or more vertebral levels of surgery increase the risk of infection significantly (p < 0.05). Low albumin level and presence of neurological disability appear to show a trend towards increased risk of infection. Use of absorbable skin closure material, age, low lymphocyte count, peri-operative administration of corticosteroids and MUST score do not appear to influence the risk of infection.

AB - Wound infection rates are generally higher in patients undergoing surgery for spinal metastasis. Risk factors of wound infection in these patients are poorly understood.Purpose: To identify demographic and clinical variables that may be associated with patients experiencing a higher wound infection rate.Study design: Retrospective study with prospectively collected data of spinal metastasis patients operated consecutively at a University Teaching Hospital, adult spine division which is a tertiary referral centre for complex spinal surgery.Patient sample: Ninety-eight patients were all surgically treated, consecutively from January 2009 to September 2011. Three patients had to be excluded due to inadequate data.Outcome measures: Physiological measures, with presence or absence of microbiologically proven infection.Methods: Various demographic and clinical data were recorded, including age, serum albumin level, blood total lymphocyte count, corticosteroid intake, Malnutrition Universal Screening Tool (MUST) score, neurological disability, skin closure material used, levels of surgery and administration of peri-operative corticosteroids. No funding was received from any sources for this study and as far as we are aware, there are no potential conflict of interest-associated biases in this study.Results: Higher probabilities of infection were associated with low albumin level, seven or more levels of surgery, use of delayed/non-absorbable skin closure material and presence of neurological disability. Of these factors, levels of surgery were found to be statistically significant at the 5 % significance level.Conclusion: Risk of infection is high (17.9 %) in patients undergoing surgery for spinal metastasis. Seven or more vertebral levels of surgery increase the risk of infection significantly (p < 0.05). Low albumin level and presence of neurological disability appear to show a trend towards increased risk of infection. Use of absorbable skin closure material, age, low lymphocyte count, peri-operative administration of corticosteroids and MUST score do not appear to influence the risk of infection.

KW - spinal metastases

KW - spine tumour

KW - spinal wound infections

KW - surgical complications

U2 - 10.1007/s00586-013-3127-4

DO - 10.1007/s00586-013-3127-4

M3 - Article

VL - 24

SP - 528

EP - 532

JO - European Spine Journal

JF - European Spine Journal

SN - 0940-6719

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Kumar S, Van Popta D, Rodrigues-Pinto R, Stephenson J, Mohammad S, Siddique I et al. Risk factors for wound infection in surgery for spinal metastasis. European Spine Journal. 2015 Mar;24(3):528-532. https://doi.org/10.1007/s00586-013-3127-4