Identifying risk factors for surgical site infections following posterior cervical laminectomy: a comprehensive analysis using ACS NSQIP data

This study aimed to identify the incidence and risk factors for SSIs using the National Surgical Quality Improvement Program (NSQIP) database registry. Surgical site infections (SSI) following posterior cervical laminectomy are serious postoperative complications that can impede recovery. There is a notable gap in the literature regarding specific risk factors for SSI in this context. We analyzed 24,241 posterior cervical laminectomy cases from the NSQIP database (2005-2017) to determine SSI incidence and identified significant risk factors using bivariate and multivariate logistic regression analyses. Among 24,241 patients, 623 (2.6%) developed SSIs, out of which 50% were superficial SSI. Bivariate analysis identified significant associated variables of SSIs, including BMI (>35 kg/m²), current smoking, alcohol abuse, insulin dependence, diabetes mellitus, dialysis, anemia, thrombocytopenia, hypoalbuminemia, high ASA scores, prolonged operating time (>196 minutes), and extended post-operative hospital stay (≥6 days). Multivariate analysis further confirmed significant predictors: BMI (OR: 2.178, p < 0.001 for extremely obese), current smoking (OR: 1.591, p < 0.001), alcohol abuse (OR: 2.345, p = 0.016), preoperative hematocrit (OR: 1.402, p = 0.002), ASA score (OR: 1.460, p = 0.022 for scores of 4-5), and hospital stay (OR: 1.582, p < 0.001 for ≥6 days). This study used a large national registry database to identify modifiable risk factors for surgical site infections (SSI) in posterior cervical laminectomy. By identifying these risk factors, physicians will be able to stratify their patients into high and low risk and thus enhancing better outcomes.