Year 2019 Vol. 27 No 6

NEUROSURGERY

V.A. BYVALTSEV 1, 2, 3, 4, I.A. STEPANOV 1, V.E. BORISOV 1, M.A. ALIEV, V.V. SHEPELEV 1

RISK FACTORS FOR SURGICAL SITE INFECTIONS AFTER POSTERIOR LUMBAR FUSION IN ELDERLY PATIENTS

Irkutsk State Medical University 1,
Irkutsk Scientific Center of Surgery and Traumatology 2,
Irkutsk State Medical Academy of Continuing Education 3,
Irkutsk Railway Clinical Hospital at Irkutsk-Passazhirskiy Station 4, Irkutsk,
The Russian Federation

Objective. To identify risk factors for the development of surgical site infections in elderly patients after posterior lumbar fusion surgery, by analyzing the preoperative, intraoperative, and postoperative parameters.
Methods. An open non-randomized single-center retrospective study was performed. The medical records analysis of patients who underwent surgery of the posterior lumbar fusion in the period from February 2012 to May 2018 was performed. According to the criteria of compliance, 437 (192 women, 245 men, the average age was 57.69.3 years (data are presented as Mσ)) elderly patients were included in the retrospective study. To compare the differences between groups of patients with diagnosed cases of surgical site infections and without them, the study included patients of the older age group without postoperative adverse events.
Results. In 11 (2.5%) cases, surgical site infections were verified (4 women, 7 men, the mean age was 59.910.1 years. The risk factors for the development of surgical site infections after performing the operation of the posterior lumbar fusion in the study group of patients are: diabetes mellitus (p=0.031), low preoperative calcium level of blood plasma (p=0.008), low preoperative and postoperative albumin levels (p=0.019 and p=0.027), a high glucose concentration in the early postoperative period (p=0.036), a low postoperative hemoglobin level (p=0.013), a posterior lumbar fusion in three or more spinal segments (p=0.005), and the duration of surgery of more than 3 hours (p=0.036), the amount of blood loss over 1000 ml (=0.014) and long-term drainage of the postoperative wound (<0.001).
Conclusions. These risk factors must be taken into account by a neurosurgeon, when conducting posterior lumbar fusion surgery in patients of the older age group, in order to minimize them and reduce the risk of surgical site infections developing.

Keywords: surgical site infections, elderly patients, risk factors, lumbar spine, posterior lumbar fusion, minimally invasive techniques
p. 674-682 of the original issue
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Address for correspondence:
664003, The Russian Federation,
Irkutsk, Krasnogo Vosstaniya Str., 1,
Irkutsk State Medical University,
Department of Neurosurgery
And Innovative Medicine.
Tel. +7 (3952) 638 528,
e-mail: vadimabyvaltsev@gmail.com,
Vadim A. Byvaltsev
Information about the authors:
Byvaltsev Vadim A., MD, Professor, Head of the Department of Neurosurgery and Innovative Medicine of Irkutsk State Medical University; Chief Neurosurgeon of Irkutsk Railway Clinical Hospital at Irkutsk-Passazhirskiy Station, Deputy Director for International and Innovative Activities of Irkutsk Scientific Center of Surgery and Traumatology; Professor of the Department of Traumatology, Orthopedics and Neurosurgery of Irkutsk State Medical Academy of Continuing Education, Irkutsk, Russian Federation.
http://orcid.org/0000-0003-4349-7101
Stepanov Ivan A., Post-Graduate Student of the Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0001-9039-9147
Borisov Vladislav E., Post-Graduate Student of the Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0001-7409-2196
Aliev Marat A., PhD, Doctoral Student of the Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0002-7676-1127
Shepelev Valeriy V., PhD, Doctoral Student of the Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, Irkutsk, Russian Federation.
https://orcid.org/0000-0001-5135-8115
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