TY - JOUR
T1 - Seasonal Effects on Surgical Site Infections Following Spine Surgery
AU - Shuman, William H.
AU - Baron, Rebecca B.
AU - Gal, Jonathan S.
AU - Li, Adam Y.
AU - Neifert, Sean N.
AU - Hannah, Theodore C.
AU - Dreher, Nickolas
AU - Schupper, Alexander J.
AU - Steinberger, Jeremy M.
AU - Caridi, John M.
AU - Choudhri, Tanvir F.
N1 - Funding Information:
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/5
Y1 - 2022/5
N2 - Background: Studies investigating seasonality as a risk factor for surgical site infections (SSIs) after spine surgery show mixed results. This study used national data to analyze seasonal effects on spine surgery SSIs. Methods: National Surgical Quality Improvement Program data (2011–2018) were queried for posterior cervical fusions (PCFs), cervical laminoplasties, posterior lumbar fusions (PLFs), lumbar laminectomies, and deformity surgeries. Patients aged >89 and procedures for tumors, fractures, infections, and nonelective indications were excluded. Patients were divided into warm (admitted April–September) and cold (admitted October–March) seasonal groups. End points were SSIs and reoperations for wound débridement/drainage. Stratified analyses were performed by surgery type and pre-versus postdischarge infections. Results: Overall (N = 208,291), SSIs were more likely in the warm season (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.08–1.23, P < 0.0001) and for PCFs (OR 1.40, 95% CI 1.08–1.80, P = 0.011), PLFs (OR 1.15, 95% CI 1.04–1.28, P = 0.006), and lumbar laminectomies (OR 1.13, 95% CI 1.03–1.25, P = 0.014). Postdischarge infections were also more likely in the warm season overall (OR 1.15, 95% CI 1.07–1.23, P < 0.0001) and for PCFs (OR 1.32, 95% CI 1.01–1.73, P = 0.041), PLFs (OR 1.14, 95% CI 1.03–1.27, P = 0.014), and lumbar laminectomies (OR 1.15, CI 1.04–1.27, P = 0.007). In-hospital infections were more likely during the warm season only for PCFs (OR 2.54, 95% CI 1.06–6.10, P = 0.037). Reoperations for infection were more likely during the warm season for PLFs (OR 1.29, 95% CI 1.08–1.54, P = 0.005). Conclusions: PCF, PLF, and lumbar laminectomy performed during the warm season had significantly higher odds of SSI, especially postdischarge SSIs. Reoperation rates for wound management were significantly increased during the warm season for PLFs. Identifying seasonal causes merits further investigation and may influence surgeon scheduling and expectations.
AB - Background: Studies investigating seasonality as a risk factor for surgical site infections (SSIs) after spine surgery show mixed results. This study used national data to analyze seasonal effects on spine surgery SSIs. Methods: National Surgical Quality Improvement Program data (2011–2018) were queried for posterior cervical fusions (PCFs), cervical laminoplasties, posterior lumbar fusions (PLFs), lumbar laminectomies, and deformity surgeries. Patients aged >89 and procedures for tumors, fractures, infections, and nonelective indications were excluded. Patients were divided into warm (admitted April–September) and cold (admitted October–March) seasonal groups. End points were SSIs and reoperations for wound débridement/drainage. Stratified analyses were performed by surgery type and pre-versus postdischarge infections. Results: Overall (N = 208,291), SSIs were more likely in the warm season (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.08–1.23, P < 0.0001) and for PCFs (OR 1.40, 95% CI 1.08–1.80, P = 0.011), PLFs (OR 1.15, 95% CI 1.04–1.28, P = 0.006), and lumbar laminectomies (OR 1.13, 95% CI 1.03–1.25, P = 0.014). Postdischarge infections were also more likely in the warm season overall (OR 1.15, 95% CI 1.07–1.23, P < 0.0001) and for PCFs (OR 1.32, 95% CI 1.01–1.73, P = 0.041), PLFs (OR 1.14, 95% CI 1.03–1.27, P = 0.014), and lumbar laminectomies (OR 1.15, CI 1.04–1.27, P = 0.007). In-hospital infections were more likely during the warm season only for PCFs (OR 2.54, 95% CI 1.06–6.10, P = 0.037). Reoperations for infection were more likely during the warm season for PLFs (OR 1.29, 95% CI 1.08–1.54, P = 0.005). Conclusions: PCF, PLF, and lumbar laminectomy performed during the warm season had significantly higher odds of SSI, especially postdischarge SSIs. Reoperation rates for wound management were significantly increased during the warm season for PLFs. Identifying seasonal causes merits further investigation and may influence surgeon scheduling and expectations.
KW - Infection
KW - NSQIP
KW - Outcomes
KW - Reoperations
KW - Season
KW - Spine surgery
UR - http://www.scopus.com/inward/record.url?scp=85125313297&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2022.01.100
DO - 10.1016/j.wneu.2022.01.100
M3 - Article
C2 - 35093573
AN - SCOPUS:85125313297
VL - 161
SP - e174-e182
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -