P53. The incidence and risk factors of wound revision following surgical treatment for spinal metastasis :a national population-based study in South Korea

BACKGROUND CONTEXT As the lifespan of patients increases due to the development of cancer treatment, the number of surgeries for spinal metastasis is gradually increasing. Wound problem is the most common and potentially fatal complication. Various factors have been suggested as risk factors for wound revision, but there are still controversies. PURPOSE The purpose of this study was to assess the incidence and risk factors for wound revision after surgical treatment of spinal metastases using a large nationwide population-based cohort. STUDY DESIGN/SETTING Retrospective study. PATIENT SAMPLE This retrospective cohort study analyzed data from the Korean National Health Insurance Service claims databases that cover the entire population of the South Korea. In this cohort study, 3,001 participants who underwent surgical treatment (corpectomy, decompression and instrumentation, instrumentation only, decompression only, and cementoplasty) for newly onset spinal metastasis between 2009 and 2017 were identified. OUTCOME MEASURES Wound revision. METHODS Cox regression analysis was performed to determine risk factor for wound revision among various factors such as age, sex, Charlson comorbidity index (CCI), concomitant cord compression, preoperative and postoperative radiation and chemotherapy, and the type of surgery were analyzed. RESULTS There were 197 cases (6.6%) of wound revision found. Only CCI and surgical method were significantly different between the group that underwent wound revision and the group that did not. The CCI was greater in the wound revision group. According to surgical methods, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of decompression only, corpectomy, instrumentation and decompression, and instrumentation only compared to cementoplasty groups were 1.3 (0.7, 2.7), 2.2 (1.2, 3.8), 2.2 (1.3, 3.6), and 2.4 (1.2, 4.7) (P for trend = 0.02). CONCLUSIONS In patients with metastatic spinal tumors, the severity of medical comorbidities and surgical method were identified as risk factors for wound revision. Systemic chemotherapy and radiation therapy were not significantly related to the rate of wound revision. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. As the lifespan of patients increases due to the development of cancer treatment, the number of surgeries for spinal metastasis is gradually increasing. Wound problem is the most common and potentially fatal complication. Various factors have been suggested as risk factors for wound revision, but there are still controversies. The purpose of this study was to assess the incidence and risk factors for wound revision after surgical treatment of spinal metastases using a large nationwide population-based cohort. Retrospective study. This retrospective cohort study analyzed data from the Korean National Health Insurance Service claims databases that cover the entire population of the South Korea. In this cohort study, 3,001 participants who underwent surgical treatment (corpectomy, decompression and instrumentation, instrumentation only, decompression only, and cementoplasty) for newly onset spinal metastasis between 2009 and 2017 were identified. Wound revision. Cox regression analysis was performed to determine risk factor for wound revision among various factors such as age, sex, Charlson comorbidity index (CCI), concomitant cord compression, preoperative and postoperative radiation and chemotherapy, and the type of surgery were analyzed. There were 197 cases (6.6%) of wound revision found. Only CCI and surgical method were significantly different between the group that underwent wound revision and the group that did not. The CCI was greater in the wound revision group. According to surgical methods, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of decompression only, corpectomy, instrumentation and decompression, and instrumentation only compared to cementoplasty groups were 1.3 (0.7, 2.7), 2.2 (1.2, 3.8), 2.2 (1.3, 3.6), and 2.4 (1.2, 4.7) (P for trend = 0.02). In patients with metastatic spinal tumors, the severity of medical comorbidities and surgical method were identified as risk factors for wound revision. Systemic chemotherapy and radiation therapy were not significantly related to the rate of wound revision.