The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study
Purpose The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome. Methods Prospective multicenter matched-cohort study...
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| Veröffentlicht in: | European spine journal 2018-10, Vol.27 (10), p.2518-2528 |
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| creator | Haddad, Sleiman Núñez-Pereira, Susana Pigrau, Carlos Rodríguez-Pardo, Dolors Vila-Casademunt, Alba Alanay, Ahmet Acaroglu, Emre R. Kleinstueck, Frank S. Obeid, Ibrahim Perez-Grueso, Francisco Javier Sanchez Pellisé, Ferran |
| description | Purpose
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.
Methods
Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. Patients developing SSI were matched to similar controls in terms of age, gender, ASA, primary or revision, extent of fusion, and use of tri-columnar osteotomies. Preoperative parameters, surgical variables, and complications were recorded. Deformity parameters and Health Related Quality of Life (HRQoL) scores were obtained preoperatively and at 6, 12, and 24 months. Independent
t
test and Fischer’s exact test were used for comparisons.
Results
444 surgical ASD patients with more than 2 years of follow-up were identified. 20 sustained an acute SSI and 60 controls were accordingly matched. No differences were observed between groups in preoperative radiological and HRQoL variables confirming comparable groups. SSI patients had longer hospital stay and more mechanical complications including proximal junctional kyphosis. Infection was associated with more unrelated complications and revisions. Deformity correction was maintained equally at the different time intervals. One death was related to SSI. SSI patients had worse overall HRQoL status at 1 year and were less likely to experience improvement. However, no significant differences were recorded thereafter.
Conclusion
SSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it’s negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease.
Graphical abstract
These slides can be retrieved under Electronic Supplementary material. |
| doi_str_mv | 10.1007/s00586-018-5583-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2035241390</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2034507217</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-9dbb9f80f164ca511404e8c1a47f02c0c1b677fc1131f0a20ed09c1842e8dd093</originalsourceid><addsrcrecordid>eNp1kU9rFTEUxYNY7LP1A7iRgBs3Y-9NMpOJOyn-g4Kbdh3y8semzEzGJLN4n8CvbdpXKwhC4AbO75xLcgh5jfAeAeRFAejHoQMcu74fecefkR0KzjpQnD0nO1ACukGiOiUvS7kDwF7B8IKcMiXZqJjYkV_Xt57GeTW20hSo836lZcs_ojUTLbE2cQne1pgW2s6TlLZq0-wLNaH6TNdU2ogpU-O2qdKyxqVRzoeU51gPD0afDx-oobOp9tY7atNSc2pb6uYO5-QkmKn4V4_zjNx8_nR9-bW7-v7l2-XHq85yyWqn3H6vwggBB2FNjyhA-NGiETIAs2BxP0gZLCLHAIaBd6AsjoL50bUrPyPvjrlrTj83X6qeY7F-mszi01Y0A94zgVxBQ9_-g96lLbdnPVCiB8lQNgqPlM2plOyDXnOcTT5oBH3fkj62pFtL-r4lzZvnzWPytp-9e3L8qaUB7AiUJi3t4_6u_n_qbzI9ntM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2034507217</pqid></control><display><type>article</type><title>The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study</title><source>SpringerLink Journals</source><creator>Haddad, Sleiman ; Núñez-Pereira, Susana ; Pigrau, Carlos ; Rodríguez-Pardo, Dolors ; Vila-Casademunt, Alba ; Alanay, Ahmet ; Acaroglu, Emre R. ; Kleinstueck, Frank S. ; Obeid, Ibrahim ; Perez-Grueso, Francisco Javier Sanchez ; Pellisé, Ferran</creator><creatorcontrib>Haddad, Sleiman ; Núñez-Pereira, Susana ; Pigrau, Carlos ; Rodríguez-Pardo, Dolors ; Vila-Casademunt, Alba ; Alanay, Ahmet ; Acaroglu, Emre R. ; Kleinstueck, Frank S. ; Obeid, Ibrahim ; Perez-Grueso, Francisco Javier Sanchez ; Pellisé, Ferran ; European Spine Study Group</creatorcontrib><description>Purpose
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.
Methods
Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. Patients developing SSI were matched to similar controls in terms of age, gender, ASA, primary or revision, extent of fusion, and use of tri-columnar osteotomies. Preoperative parameters, surgical variables, and complications were recorded. Deformity parameters and Health Related Quality of Life (HRQoL) scores were obtained preoperatively and at 6, 12, and 24 months. Independent
t
test and Fischer’s exact test were used for comparisons.
Results
444 surgical ASD patients with more than 2 years of follow-up were identified. 20 sustained an acute SSI and 60 controls were accordingly matched. No differences were observed between groups in preoperative radiological and HRQoL variables confirming comparable groups. SSI patients had longer hospital stay and more mechanical complications including proximal junctional kyphosis. Infection was associated with more unrelated complications and revisions. Deformity correction was maintained equally at the different time intervals. One death was related to SSI. SSI patients had worse overall HRQoL status at 1 year and were less likely to experience improvement. However, no significant differences were recorded thereafter.
Conclusion
SSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it’s negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease.
Graphical abstract
These slides can be retrieved under Electronic Supplementary material.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-018-5583-3</identifier><identifier>PMID: 29728924</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Infections ; Kyphosis ; Medicine ; Medicine & Public Health ; Morbidity ; Neurosurgery ; Original Article ; Quality of life ; Surgery ; Surgical Orthopedics ; Surgical outcomes ; Surgical site infections</subject><ispartof>European spine journal, 2018-10, Vol.27 (10), p.2518-2528</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>European Spine Journal is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-9dbb9f80f164ca511404e8c1a47f02c0c1b677fc1131f0a20ed09c1842e8dd093</citedby><cites>FETCH-LOGICAL-c372t-9dbb9f80f164ca511404e8c1a47f02c0c1b677fc1131f0a20ed09c1842e8dd093</cites><orcidid>0000-0002-3662-9009</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00586-018-5583-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00586-018-5583-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29728924$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haddad, Sleiman</creatorcontrib><creatorcontrib>Núñez-Pereira, Susana</creatorcontrib><creatorcontrib>Pigrau, Carlos</creatorcontrib><creatorcontrib>Rodríguez-Pardo, Dolors</creatorcontrib><creatorcontrib>Vila-Casademunt, Alba</creatorcontrib><creatorcontrib>Alanay, Ahmet</creatorcontrib><creatorcontrib>Acaroglu, Emre R.</creatorcontrib><creatorcontrib>Kleinstueck, Frank S.</creatorcontrib><creatorcontrib>Obeid, Ibrahim</creatorcontrib><creatorcontrib>Perez-Grueso, Francisco Javier Sanchez</creatorcontrib><creatorcontrib>Pellisé, Ferran</creatorcontrib><creatorcontrib>European Spine Study Group</creatorcontrib><title>The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.
Methods
Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. Patients developing SSI were matched to similar controls in terms of age, gender, ASA, primary or revision, extent of fusion, and use of tri-columnar osteotomies. Preoperative parameters, surgical variables, and complications were recorded. Deformity parameters and Health Related Quality of Life (HRQoL) scores were obtained preoperatively and at 6, 12, and 24 months. Independent
t
test and Fischer’s exact test were used for comparisons.
Results
444 surgical ASD patients with more than 2 years of follow-up were identified. 20 sustained an acute SSI and 60 controls were accordingly matched. No differences were observed between groups in preoperative radiological and HRQoL variables confirming comparable groups. SSI patients had longer hospital stay and more mechanical complications including proximal junctional kyphosis. Infection was associated with more unrelated complications and revisions. Deformity correction was maintained equally at the different time intervals. One death was related to SSI. SSI patients had worse overall HRQoL status at 1 year and were less likely to experience improvement. However, no significant differences were recorded thereafter.
Conclusion
SSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it’s negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease.
Graphical abstract
These slides can be retrieved under Electronic Supplementary material.</description><subject>Infections</subject><subject>Kyphosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Quality of life</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Surgical outcomes</subject><subject>Surgical site infections</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU9rFTEUxYNY7LP1A7iRgBs3Y-9NMpOJOyn-g4Kbdh3y8semzEzGJLN4n8CvbdpXKwhC4AbO75xLcgh5jfAeAeRFAejHoQMcu74fecefkR0KzjpQnD0nO1ACukGiOiUvS7kDwF7B8IKcMiXZqJjYkV_Xt57GeTW20hSo836lZcs_ojUTLbE2cQne1pgW2s6TlLZq0-wLNaH6TNdU2ogpU-O2qdKyxqVRzoeU51gPD0afDx-oobOp9tY7atNSc2pb6uYO5-QkmKn4V4_zjNx8_nR9-bW7-v7l2-XHq85yyWqn3H6vwggBB2FNjyhA-NGiETIAs2BxP0gZLCLHAIaBd6AsjoL50bUrPyPvjrlrTj83X6qeY7F-mszi01Y0A94zgVxBQ9_-g96lLbdnPVCiB8lQNgqPlM2plOyDXnOcTT5oBH3fkj62pFtL-r4lzZvnzWPytp-9e3L8qaUB7AiUJi3t4_6u_n_qbzI9ntM</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Haddad, Sleiman</creator><creator>Núñez-Pereira, Susana</creator><creator>Pigrau, Carlos</creator><creator>Rodríguez-Pardo, Dolors</creator><creator>Vila-Casademunt, Alba</creator><creator>Alanay, Ahmet</creator><creator>Acaroglu, Emre R.</creator><creator>Kleinstueck, Frank S.</creator><creator>Obeid, Ibrahim</creator><creator>Perez-Grueso, Francisco Javier Sanchez</creator><creator>Pellisé, Ferran</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3662-9009</orcidid></search><sort><creationdate>20181001</creationdate><title>The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study</title><author>Haddad, Sleiman ; Núñez-Pereira, Susana ; Pigrau, Carlos ; Rodríguez-Pardo, Dolors ; Vila-Casademunt, Alba ; Alanay, Ahmet ; Acaroglu, Emre R. ; Kleinstueck, Frank S. ; Obeid, Ibrahim ; Perez-Grueso, Francisco Javier Sanchez ; Pellisé, Ferran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-9dbb9f80f164ca511404e8c1a47f02c0c1b677fc1131f0a20ed09c1842e8dd093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Infections</topic><topic>Kyphosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Quality of life</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Surgical outcomes</topic><topic>Surgical site infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haddad, Sleiman</creatorcontrib><creatorcontrib>Núñez-Pereira, Susana</creatorcontrib><creatorcontrib>Pigrau, Carlos</creatorcontrib><creatorcontrib>Rodríguez-Pardo, Dolors</creatorcontrib><creatorcontrib>Vila-Casademunt, Alba</creatorcontrib><creatorcontrib>Alanay, Ahmet</creatorcontrib><creatorcontrib>Acaroglu, Emre R.</creatorcontrib><creatorcontrib>Kleinstueck, Frank S.</creatorcontrib><creatorcontrib>Obeid, Ibrahim</creatorcontrib><creatorcontrib>Perez-Grueso, Francisco Javier Sanchez</creatorcontrib><creatorcontrib>Pellisé, Ferran</creatorcontrib><creatorcontrib>European Spine Study Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haddad, Sleiman</au><au>Núñez-Pereira, Susana</au><au>Pigrau, Carlos</au><au>Rodríguez-Pardo, Dolors</au><au>Vila-Casademunt, Alba</au><au>Alanay, Ahmet</au><au>Acaroglu, Emre R.</au><au>Kleinstueck, Frank S.</au><au>Obeid, Ibrahim</au><au>Perez-Grueso, Francisco Javier Sanchez</au><au>Pellisé, Ferran</au><aucorp>European Spine Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2018-10-01</date><risdate>2018</risdate><volume>27</volume><issue>10</issue><spage>2518</spage><epage>2528</epage><pages>2518-2528</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
The impact of deep surgical site infection (SSI) on surgical outcomes after adult spinal deformity (ASD) surgery is still unclear. We aimed to study the morbidity of SSI in ASD and its impact on deformity correction and functional outcome.
Methods
Prospective multicenter matched-cohort study including consecutively enrolled ASD patients. Patients developing SSI were matched to similar controls in terms of age, gender, ASA, primary or revision, extent of fusion, and use of tri-columnar osteotomies. Preoperative parameters, surgical variables, and complications were recorded. Deformity parameters and Health Related Quality of Life (HRQoL) scores were obtained preoperatively and at 6, 12, and 24 months. Independent
t
test and Fischer’s exact test were used for comparisons.
Results
444 surgical ASD patients with more than 2 years of follow-up were identified. 20 sustained an acute SSI and 60 controls were accordingly matched. No differences were observed between groups in preoperative radiological and HRQoL variables confirming comparable groups. SSI patients had longer hospital stay and more mechanical complications including proximal junctional kyphosis. Infection was associated with more unrelated complications and revisions. Deformity correction was maintained equally at the different time intervals. One death was related to SSI. SSI patients had worse overall HRQoL status at 1 year and were less likely to experience improvement. However, no significant differences were recorded thereafter.
Conclusion
SSI significantly affects the first postoperative year after posterior ASD surgery. It is associated with more complications, unrelated revisions, and worst quality of life. However it’s negative impact seems to be diluted by the second postoperative year as differences in HRQoL scores between the two groups decrease.
Graphical abstract
These slides can be retrieved under Electronic Supplementary material.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29728924</pmid><doi>10.1007/s00586-018-5583-3</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3662-9009</orcidid></addata></record> |
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| source | SpringerLink Journals |
| subjects | Infections Kyphosis Medicine Medicine & Public Health Morbidity Neurosurgery Original Article Quality of life Surgery Surgical Orthopedics Surgical outcomes Surgical site infections |
| title | The impact of deep surgical site infection on surgical outcomes after posterior adult spinal deformity surgery: a matched control study |
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