Evidence map›Paper›PMID 27190732›Full record

ArticleGlobal spine journal2016

The Burden of Clostridium difficile after Cervical Spine Surgery.

Javier Z Guzman, Branko Skovrlj, Edward S Rothenberg, Young Lu, Steven McAnany, Samuel K Cho, Andrew C Hecht, Sheeraz A Qureshi

Open access · goldAbstract read
In one paragraph

Article in Global spine journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Risk Factors of Patients With Diarrhea for HavingFrontiers in microbiology · 2022
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Javier Z GuzmanDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Branko SkovrljDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Edward S RothenbergDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Young LuDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Steven McAnanyDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Samuel K ChoDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Andrew C HechtDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Sheeraz A QureshiDepartment of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
Icahn School of Medicine at Mount Sinai · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Study Design Retrospective database analysis. Objective The purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after cervical spine surgery. Methods A total of 1,602,130 cervical spine surgeries from the Nationwide Inpatient Sample database from 2002 to 2011 were included. Patients were included for study based on International Classification of Diseases Ninth Revision, Clinical Modification procedural codes for cervical spine surgery for degenerative spine diagnoses. Baseline patient characteristics were determined. Multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. Results Incidence of C. difficile infection in postoperative cervical spine surgery hospitalizations is 0.08%, significantly increased since 2002 (p < 0.0001). The odds of postoperative C. difficile infection were significantly increased in patients with comorbidities such as congestive heart failure, renal failure, and perivascular disease. Circumferential cervical fusion (odds ratio [OR] = 2.93, p < 0.0001) increased the likelihood of developing C. difficile infection after degenerative cervical spine surgery. C. difficile infection after cervical spine surgery results in extended length of stay (p < 0.0001) and increased hospital costs (p < 0.0001). Mortality rate in patients who develop C. difficile after cervical spine surgery is nearly 8% versus 0.19% otherwise (p < 0.0001). Moreover, multivariate analysis revealed C. difficile to be a significant predictor of inpatient mortality (OR = 3.99, p < 0.0001). Conclusions C. difficile increases the risk of in-hospital mortality and costs approximately $6,830,695 per year to manage in patients undergoing elective cervical spine surgery. Patients with comorbidities such as renal failure or congestive heart failure have increased probability of developing infection after surgery. Accepted antibiotic guidelines in this population must be followed to decrease the risk of developing postoperative C. difficile colitis.

Indexed as

cervical spine surgeryclostridium difficilecostdatabase analysisinfectionmortalityoutcomes

Identifiers

PMID27190732
PMCPMC4868580
OpenAlexW1652070957

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.