scholarly journals Validation of a previously published risk severity score predicting surgical site infection after spinal deformity surgery in patients with cerebral palsy utilizing a large, separate cohort

2018 ◽  
Vol 60 ◽  
pp. 3-4
Keyword(s):  
Cerebral Palsy ◽  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Severity Score ◽  
Site Infection ◽  
Spinal Deformity Surgery ◽  
Separate Cohort

scholarly journals Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

2020 ◽  
pp. 219256822097822
Author(s):  
Muyi Wang ◽  
Liang Xu ◽  
Bo Yang ◽  
Changzhi Du ◽  
Zezhang Zhu ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Recurrent Infection ◽  
Implant Removal ◽  
Site Infection ◽  
Initial Surgery ◽  
Spinal Deformity Surgery ◽  
Solid Fusion ◽  
Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

Risk Factors Associated with Surgical Site Infection in Pediatric Patients Undergoing Spinal Deformity Surgery

JBJS Reviews ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e0163
Author(s):  
Hiroko Matsumoto ◽  
Matthew E. Simhon ◽  
Megan L. Campbell ◽  
Michael G. Vitale ◽  
Elaine L. Larson
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
Site Infection ◽  
Factors Associated ◽  
Spinal Deformity Surgery

Surgical site infection prevention protocol for pediatric spinal deformity surgery: does it make a difference?

2020 ◽  
Vol 8 (5) ◽  
pp. 931-938
Author(s):  
Connie Poe-Kochert ◽  
Jilan L. Shimberg ◽  
George H. Thompson ◽  
Jochen P. Son-Hing ◽  
Christina K. Hardesty ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Deformity ◽  
Infection Prevention ◽  
Site Infection ◽  
Spinal Deformity Surgery ◽  
Prevention Protocol

scholarly journals Spinal Deformity Surgery in Pediatric Patients With Cerebral Palsy: A National-Level Analysis of Inpatient and Postdischarge Outcomes

2020 ◽  
pp. 219256822096007
Author(s):  
Nathan J. Lee ◽  
Michael Fields ◽  
Venkat Boddapati ◽  
Justin Mathew ◽  
Daniel Hong ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Respiratory Failure ◽  
Length Of Stay ◽  
Acute Respiratory Failure ◽  
Spinal Fusion ◽  
Spinal Deformity ◽  
Pediatric Patients ◽  
National Level ◽  
Spinal Deformity Surgery ◽  
Tract Infections

Study Design: Retrospective cohort. Objective: To provide a national-level assessment of the short-term outcomes after spinal deformity surgery in pediatric patients with cerebral palsy. Methods: A national, prospectively collected database was queried to identify pediatric (≤18 years) patients with cerebral palsy, who underwent spinal fusion surgery from 2012 to 2017. Separate multivariate analyses were performed for the primary outcomes of interest including extended length of stay (>75th percentile, >8 days), and readmissions within 90 days after the index admission. Results: A total of 2856 patients were reviewed. The mean age ± standard deviation was 12.8 ± 2.9 years, and 49.4% of patients were female. The majority of patients underwent a posterior spinal fusion (97.0%) involving ≥8 levels (79.9%) at a teaching hospital (96.6%). Top medical complications (24.5%) included acute respiratory failure requiring mechanical ventilation (11.4%), paralytic ileus (8.2%), and urinary tract infections (4.6%). Top surgical complications (40.7%) included blood transfusion (35.6%), wound complication (4.9%), and mechanical complication (2.7%). The hospital cost for patients with a length of hospital stay >8 days ($113 669) was nearly double than that of those with a shorter length of stay ($68 411). The 90-day readmission rate was 17.6% (mean days to readmission: 30.2). The most common reason for readmission included wound dehiscence (21.1%), surgical site infection (19.1%), other infection (18.9%), dehydration (16.9%), feeding issues (14.5%), and acute respiratory failure (13.1%). Notable independent predictors for 90-day readmissions included preexisting pulmonary disease (odds ratio [OR] 1.5), obesity (OR 3.4), cachexia (OR 27), nonteaching hospital (OR 3.5), inpatient return to operating room (OR 1.9), and length of stay >8 days (OR 1.5). Conclusions: Efforts focused on optimizing the perioperative pulmonary, hematological, and nutritional status as well as reducing wound complications appear to be the most important for improving clinical outcomes.

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