Identification of Risk Factors Associated with Surgical Site Infection following Spinal Surgery
PI: Trish M. Perl, M.D., M.Sc.
Sponsor: Centers for Disease Control and Prevention (CDC) – pending Surgical site infections (SSIs) are the second most common cause of nosocomial infections in the United States. SSI is the most common type of nosocomial infection in patients undergoing surgery and leads to increased morbidity, mortality, length of hospital stay, and healthcare costs. SSI rates following laminectomy and laminectomy with spinal fusion were 1.2% and 2.4% respectively for 1992-1998. Rates of SSI have been reported to be consistently higher when spinal fusion is performed. Rates from individual institutions vary, and the Johns Hopkins Hospital noted elevated rates in 2001-2002. The National Nosocomial Infection Surveillance (NNIS) system basic SSI risk index is based on 3 criteria; the American Society of Anesthesiologists (ASA) score, duration of surgery, and wound class. Publications have identified diverse risk factors for SSI following spinal surgery, but most have been descriptive rather than presenting statistical analysis of data. Recent studies have identified post-operative incontinence, posterior approach, surgery for tumor resection, morbid obesity, dural tear with use of glue, and morphine nerve paste as independent risk factors for spinal surgery. The studies were small, produced disparate results, and excluded analysis of procedures performed by orthopedic surgeons. More investigation is needed to elucidate the risk factors for SSI following spinal surgery so that interventions can be designed to lower morbidity and mortality in these patients. This study is currently underway at Johns Hopkins University and is being considered for funding as a multi-center project in conjunction with the Epicenters of Excellence Program through the CDC. For more information on this study please email or contact Lisa Maragakis, M.D. at (410) 955-8384, or Kathleen Speck or Meg Gifford at (410) 614-6206. |
