Risk Factors for Surgical Site Infections Following Neurosurgical Spinal Fusion Operations: A Case Control Study

2016 ◽  
Vol 38 (3) ◽  
pp. 340-347 ◽  
Author(s):  
Thomas L. Walsh ◽  
Ashley M. Querry ◽  
Sheila McCool ◽  
Alison L. Galdys ◽  
Kathleen A. Shutt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Fusion ◽  
Protective Factor ◽  
Case Control Study ◽  
Care Center ◽  
Surgical Site Infections ◽  
Case Control ◽  
Study Cohort ◽  
Retrospective Case ◽  
Control Study

OBJECTIVETo determine risk factors for the development of surgical site infections (SSIs) in neurosurgery patients undergoing spinal fusion.DESIGNRetrospective case-control study.SETTINGLarge, academic, quaternary care center.PATIENTSThe study population included all neurosurgery patients who underwent spinal fusion between August 1, 2009, and August 31, 2013. Cases were defined as patients in the study cohort who developed an SSI. Controls were patients in the study cohort who did not develop an SSI.METHODSTo achieve 80% power with an ability to detect an odds ratio (OR) of 2, we performed an unmatched case-control study with equal numbers of cases and controls.RESULTSDuring the study period, 5,473 spinal fusion procedures were performed by neurosurgeons in our hospital. With 161 SSIs recorded during the study period, the incidence of SSIs associated with these procedures was 2.94%. While anterior surgical approach was found to be a protective factor (OR, 0.20; 95% confidence interval [CI], 0.08–0.52), duration of procedure (OR, 1.58; 95% CI, 1.29–1.93), American Society of Anesthesiologists score of 3 or 4 (OR, 1.79; 95% CI, 1.00–3.18), and hospitalization within the prior 30 days (OR, 5.8; 95% CI, 1.37–24.57) were found in multivariate analysis to be independent predictors of SSI following spinal fusion. Prior methicillin-resistant Staphylococcus aureus (MRSA) nares colonization was highly associated with odds 20 times higher of SSI following spinal fusion (OR, 20.30; 95% CI, 4.64–8.78).CONCLUSIONSIn additional to nonmodifiable risk factors, prior colonization with MRSA is a modifiable risk factor very strongly associated with development of SSI following spinal fusion.Infect Control Hosp Epidemiol 2017;38:348–352

Surgical-Site Infection Following Spinal Fusion: A Case-Control Study in a Children's Hospital

2003 ◽  
Vol 24 (8) ◽  
pp. 591-595 ◽  
Author(s):  
Annie-Claude Labbé ◽  
Anne-Marie Demers ◽  
Ramona Rodrigues ◽  
Vincent Arlet ◽  
Kim Tanguay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Spinal Fusion ◽  
Spinal Surgery ◽  
Case Control Study ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Case Control ◽  
Gram Negative Organisms ◽  
Control Study

AbstractObjectives:To determine the rates of surgical-site infections (SSIs) after spinal surgery and to identify the risk factors associated with infection.Design:SSIs had been identified by active prospective surveillance. A case-control study to identify risk factors was performed retrospectively.Setting:University-associated, tertiary-care pediatric hospital.Patients:All patients who underwent spinal surgery between 1994 and 1998. Cases were all patients who developed an SSI after spinal surgery. Controls were patients who did not develop an SSI, matched with the cases for the presence or absence of myelodysplasia and for the surgery date closest to that of the case.Results:There were 10 infections following 125 posterior spinal fusions, 4 infections after 50 combined anterior-posterior fusions, and none after 95 other operations. The infection rate was higher in patients with myelodysplasia (32 per 100 operations) than in other patients (3.4 per 100 operations; relative risk = 9.45; P < .001). Gram-negative organisms were more common in early infections and Staphylococcus aureus in later infections. Most infections occurred in fusion involving sacral vertebrae (odds ratio [OR] = 12.0; P = .019). Antibiotic prophylaxis was more frequently suboptimal in cases than in controls (OR = 5.5; P = .034). Five patients required removal of instrumentation and 4 others required surgical debridement.Conclusions:Patients with myelodysplasia are at a higher risk for SSIs after spinal fusion. Optimal antibiotic prophylaxis may reduce the risk of infection, especially in high-risk patients such as those with myelodysplasia or those undergoing fusion involving the sacral area.

scholarly journals Risk Factors for Surgical Site Infections Following Spinal Fusion Procedures: A Case-Control Study

2011 ◽  
Vol 53 (7) ◽  
pp. 686-692 ◽  
Author(s):  
S. B. Rao ◽  
G. Vasquez ◽  
J. Harrop ◽  
M. Maltenfort ◽  
N. Stein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Fusion ◽  
Case Control Study ◽  
Surgical Site Infections ◽  
Case Control ◽  
Control Study

scholarly journals Differences in risk factors of malignancy between men and women with type 2 diabetes: A retrospective case-control study

Oncotarget ◽  
2017 ◽  
Vol 8 (40) ◽  
pp. 66940-66950 ◽  
Author(s):  
Mariusz Dąbrowski ◽  
Elektra Szymańska-Garbacz ◽  
Zofia Miszczyszyn ◽  
Tadeusz Dereziński ◽  
Leszek Czupryniak
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Men And Women ◽  
Control Study

scholarly journals Analisis Faktor Fetus dan Tali Pusat terhadap Risiko Asphyxia Perinatal di Surakarta

2020 ◽  
Vol 3 (1) ◽  
pp. 16
Author(s):  
Siti Lestari ◽  
Dyah Dwi Astuti ◽  
Fachriza Malika Ramadhani
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Chi Square ◽  
Fetal Position ◽  
Control Study

Asfiksia perinatal merujuk pada kekurangan oksigen selama persalinan, sehingga berpotensi menyebabkan kematian dan kecacatan. WHO memperkirakan  4 juta anak terlahir dengan asfiksia setiap tahun, dimana 1 juta di antaranya meninggal dan 1 juta anak bertahan hidup dengan gejala sisa neurologis yang parah. Penelitian ini bertujuan untuk menganalisis faktor risiko fetal dan tali pusat pada asfiksia neonatal.Penelitian dilakukan di lakukan di RS Dr Moewardi Surakarta dengan pendekatan  quantitative retrospective case control study. Data diambil dari rekam medis antara  tahun 2013-2018. Penelitan ini melibatkan  264 neonatal yang terdiri dari 88 kelompok kasus dan 176  kelompok control. Kelompok kasus adalah bayi dengan diagnosa  asfiksia yang  dilakukan analisis terhadap faktor risiko fetal, sedangkan bayi yang tidak mengalami asfiksia dijadikan  kelompok kontrol. Hasil analisis statistik uji Chi-Square dan Fisher Exact ditemukan bahwa  kelahiran prematur (OR 2,07 CI 95% P 0,02), persalinan dengan tindakan (OR 3,61 CI 95% P 0,00), berat bayi (OR 2,85 CI 95% P 0,00), posisi janin (OR 2,37 CI 95% P 0,05), tali pusat ( QR 3,071 CI 95%  P 0,01)  berisiko terhadap insiden asfiksia perinatal. Air ketuban yang bercampur meconium (OR 1,51 CI 95% P 0,16) tidak memiliki risiko  dengan Asfiksia perinatal. Kesimpulan: Risiko terhadap insiden asfiksia perinatal  meliputi kelahiran prematur, persalinan dengan tindakan, berat bayi, posisi janin,  dan tali pusat.Perinatal asphyxia refers to a lack of oxygen during labor, which has the potential to cause death and disability. WHO estimates  4 million children born with asphyxia each year, in  which 1 million dies and 1 million survive with severe neurological sequelae. This study aims to analyze fetal and umbilical risk factors in neonatal asphyxia.This research is a quantitative retrospective case-control study, which was conducted at The Dr. Moewardi  hospital,  Surakarta. Data was taken from  medical records from 2013-2018. The case group was patients diagnosed  asphyxia, while those who did not experience asphyxia were treated as a control group.  A total of 264  samples, consisting of 88 case group respondents and 176 control group respondents. Statistical analysis Chi- Square and Fisher Exact found that preterm birth (OR 2.07 CI 95% P 0.02), labor with instrument or complication (OR 3.61 CI 95% P 0.00), infant weight (OR 2.85 CI 95% P 0, 00), fetal position (OR 2.37 CI 95% P 0.05), umbilical cord (QR 3.071 CI 95% P 0.01) are at risk for the incidence of perinatal Asphyxia. The amniotic fluid mixed with meconium (OR 1.51 CI 95% P 0.16) has no risk with perinatal asphyxia.The risk factors of incidences of perinatal asphyxia were  preterm birth, labor with instrument or complication, baby weight, fetal position and umbilical cord. 

scholarly journals Prehospital delay is an important risk factor for mortality in community-acquired bloodstream infection (CA-BSI): a matched case–control study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e052582
Author(s):  
Martin Holmbom ◽  
Maria Andersson ◽  
Sören Berg ◽  
Dan Eklund ◽  
Pernilla Sobczynski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Bloodstream Infection ◽  
Case Control Study ◽  
Case Control ◽  
Important Risk Factor ◽  
Retrospective Case ◽  
Prehospital Delay ◽  
All Cause Mortality ◽  
Control Study

ObjectivesThe aim of this study was to identify prehospital and early hospital risk factors associated with 30-day mortality in patients with blood culture-confirmed community-acquired bloodstream infection (CA-BSI) in Sweden.MethodsA retrospective case–control study of 1624 patients with CA-BSI (2015–2016), 195 non-survivors satisfying the inclusion criteria were matched 1:1 with 195 survivors for age, gender and microorganism. All forms of contact with a healthcare provider for symptoms of infection within 7 days prior CA-BSI episode were registered. Logistic regression was used to analyse risk factors for 30-day all-cause mortality.ResultsOf the 390 patients, 61% (115 non-survivors and 121 survivors) sought prehospital contact. The median time from first prehospital contact till hospital admission was 13 hours (6–52) for non-survivors and 7 hours (3–24) for survivors (p<0.01). Several risk factors for 30-day all-cause mortality were identified: prehospital delay OR=1.26 (95% CI: 1.07 to 1.47), p<0.01; severity of illness (Sequential Organ Failure Assessment score) OR=1.60 (95% CI: 1.40 to 1.83), p<0.01; comorbidity score (updated Charlson Index) OR=1.13 (95% CI: 1.05 to 1.22), p<0.01 and inadequate empirical antimicrobial therapy OR=3.92 (95% CI: 1.64 to 9.33), p<0.01. In a multivariable model, prehospital delay >24 hours from first contact remained an important risk factor for 30-day all-cause mortality due to CA-BSI OR=6.17 (95% CI: 2.19 to 17.38), p<0.01.ConclusionPrehospital delay and inappropriate empirical antibiotic therapy were found to be important risk factors for 30-day all-cause mortality associated with CA-BSI. Increased awareness and earlier detection of BSI in prehospital and early hospital care is critical for rapid initiation of adequate management and antibiotic treatment.

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