Analysis Of Postoperative Spinal Surgery Infections At An Elderly Care Center

Background: Surgical site infection (SSI) is a frequent complication after spine arthrodesis with implant placement (ICA). We made the diagnosis of the local situation because the suspicion of higher rates of ICA infections. The objectives is to analyze the epidemiological and microbiological profile of patients with diagnosis of SSI after ICA and to compare the rates in 2014 and 2017 periods. Methods & Materials: Retrospective analysis of medical history of patients with SSI after ICA diagnosis since January 2011 to October 2017. We compared infection rates in 2014 (group 1) and 2017 (group 2). Intra-surgical variables were monitored. Microbiological isolates were analyzed. The X2 test is used without yacht correction with a value of p < or = 0.05 to determine statistical significance. Results: 316 ICA were performed. 54 episodes of SSI were documented. Overall infection rate: 17.08%. Median age: 72 years (range: 54-83). 77.7% was women. The most common comorbidities were smoking, diabetes and cardiovascular pathology. The SSI localization were: lumbar (n = 27) and dorsolumbar (n = 12). In 2011, the rate was 23.52%. In group 1 the infection rate was 7.81% and reached 20.9% in group 2 with statistically significant changes between both groups (x2: 3.892, p: 0.0243). The intraoperative variables were: median surgical time: 160 minutes group 1 versus 215 minutes group 2 (ratio 1.3 times higher). No changes were observed in ASA (II/III), pre-surgical antibiotic prophylaxis (cefazolin) or in the use of local vancomycin between both groups. Predominant microbiological isolation: 2011 positive cocci, 2014 gram-negative bacilli, 2017 without predominance. Conclusion: In 2011 the prevention of hospital infections was intensified, as a measure of control of a high rate of column SSI, achieving its decrease in 2014. In 2017, a statistically significant increase was registered. Intraoperative variables were analyzed and an increase in surgical time was evidenced between the groups. We consider necessary to increase surveillance of patients’ risk factors, preoperative evaluation and surgical procedure as a priority of the infection control program.