Risk Factors Associated with Postoperative Infection in Cancer Patients Undergoing Spine Surgery

Abstract

To determine the rate of and main risk factors for postoperative infection in cancer patients who underwent spine surgery in the last 5 years in order to determine whether there is an association between postoperative infection and increased mortality during hospitalization. METHODS: All cancer patients who underwent surgical procedures between January 2015 and December 2019 at a single hospital specializing in spine cancer surgery were analyzed. The primary outcome of interest was postoperative infection. Bivariate logistic regression was used to estimate the odds ratio and 95% confidence interval for each variable in relation to the occurrence of infection. RESULTS: We evaluated 324 patients, including 176 men (54.3%) and 148 women (45.7%) with a mean age of 56 years. The incidence of postoperative infection was 20.37%. Of the 324 patients, 39 died during hospitalization (12%). CONCLUSIONS: Surgical time greater than 4 hours, surgical instrumented levels greater than 6, and an Eastern Cooperative Oncology Group of 3 or 4 were associated with an increased risk of postoperative infection, but these factors did not lead to an increase in mortality during hospitalization.

Incidence and Risk Factors for Wound Revision after Surgical Treatment of Spinal Metastasis: A National Population-Based Study in South Korea

“…While past research has explored the incidence and risk factors of wound complications in spinal metastasis tumor surgery, the majority of these studies were limited by being conducted at single institutions with fewer patients [2,4,6,15,22]. As a result, their findings were often heterogenous.…”

“…It has been reported that various surgical-related factors contribute to an increased risk of wound complications, and particularly, the risk increases as the extent of the surgery becomes more extensive [2,6,7]. While there are cases where more extensive surgery is necessary, accepting the risk of wound complications such as paralysis, there is also deliberation in cases of asymptomatic nerve compression as to whether to make the surgery more extensive by adding decompression.…”

“…Among the preoperative factors, the one most frequently reported is the patient's overall condition. Some studies have demonstrated a correlation between wound complications and assessments such as the Karnofsky Performance Scale (KPS) or the Eastern Cooperative Oncology Group (ECOG) performance status, which evaluate a patient's ability to care for themselves, their daily activity, and their physical ability [2,6]. However, the patient's condition can be temporary, and these evaluations can be subjective [16].…”

Association between malnutrition and surgical site wound infection among spinal surgery patients: A meta‐analysis

“…A surgical site infection (SSI) is one of the most common complications occurring after spinal surgery, with incidence rates ranging from 0.7% to 12% 1–3 . Despite the implementation of systematic prevention strategies in clinical practice, SSIs remain a concern for surgeons.…”

“…A surgical site infection (SSI) is one of the most common complications occurring after spinal surgery, with incidence rates ranging from 0.7% to 12%. [1][2][3] Despite the implementation of systematic prevention strategies in clinical practice, SSIs remain a concern for surgeons. Many risk factors are associated with spinal SSIs, including diabetes, hypertension, smoking, alcohol abuse and steroid use.…”