• Ana I Hijas-Gómez, Rosa M Egea-Gámez, Javier Martínez-Martín, Rafael González-Díaz, José I Losada-Viñas, and Gil Rodríguez-Caravaca.
• Department of Preventive Medicine and Public Health. University Hospital Fundación Alcorcón, Madrid, Spain.
• Spine. 2017 May 15; 42 (10): 748-754.

Study DesignProspective cohort study.ObjectiveTo study risk factors linked to spinal fusion surgical wound infection (SWI) incidence and compare the incidence with rates in Madrid Region, Spain and United States as a whole.Summary Of Background DataSWI is one of the complications posed by spinal surgery. Indeed, spinal surgery has a higher infection rate than do other orthopedic surgeries such as total hip or knee arthroplasty. The study of risk factors that are susceptible to be modified will enable both the incidence of SWI and, by extension, related morbidity, mortality, and costs to be reduced.MethodsAll patients undergoing spinal fusion at a tertiary hospital from June 2011 to June 2014 were included. Infection rate was calculated, and the association between risk factors and SWI incidence was assessed by reference to odds ratio (OR) with univariate and multivariate analysis.ResultsThe study population (n = 892) had a SWI rate of 3.9%. The standardized infection ratio of our hospital was 0.58 with respect to the Madrid Region, 0.76 with respect to Spain's national rate and 2.05 with respect to the US NHSN/CDC. The multivariate analysis showed that predictive factors of SWI were diabetes mellitus (OR 2.81, 95% confidence interval, CI: 1.18-6.72, P < 0.05), chronic obstructive pulmonary disease (COPD) (OR 5.16, 95% CI: 2.04-13.08, P < 0.05), duration of surgery higher than the 75th percentile (OR 5.39, 95% CI: 1.77-110.84, P < 0.05) and dirty surgery (OR 14.01, 95% CI: 1.01-28.88, P < 0.05).ConclusionIndependent risk factors for SWI in spinal fusion are existence of diabetes mellitus, COPD, duration of surgery higher than the 75th percentile and dirty surgery. Knowing these risk factors enables action to be taken to reduce the SWI rate.Level Of Evidence3.

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