Evidence map›Paper›PMID 31328087›Full record

ArticleInternational journal of spine surgery2019

What Factors Predict Failure of Nonsurgical Management of a Lumbar Surgical Site Infection?

Christopher J Lucasti, Myles Dworkin, Kris E Radcliff, Kristen Nicholson, Christopher J Lucasti, Barrett I Woods

Abstract read
In one paragraph

Article in International journal of spine surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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

1 citing paper in PubMed.

  1. Article
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

6 authors.

Christopher J LucastiSidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
Myles DworkinSidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
Kris E RadcliffDepartment of Orthopaedic Surgery, Thomas Jefferson University and The Rothman Institute, Philadelphia, Pennsylvania.
Kristen NicholsonDepartment of Orthopaedic Surgery, Thomas Jefferson University and The Rothman Institute, Philadelphia, Pennsylvania.
Christopher J LucastiSouth Jersey Infectious Disease, Somers Point, New Jersey.
Barrett I WoodsDepartment of Orthopaedic Surgery, Thomas Jefferson University and The Rothman Institute, Philadelphia, Pennsylvania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne of the most frequent complications of invasive lumbar spine surgery is postoperative surgical site infections (SSIs). Although there are absolute criteria for surgical intervention (progressive neurologic deficit, sepsis, failure of medical management), the treatment of routine, uncomplicated SSIs remains somewhat unclear. The purpose of this study was to evaluate the outcome of a series of patients with postoperative surgical site infections who were treated with or without surgical intervention. The primary clinical outcome was the assessment of whether medical management alone would be sufficient to eradicate the infection.

methodsA retrospective review of consecutive patients who underwent lumbar surgery complicated by spine infection between 2011 and 2017 was performed in order to determine what factors, if any, resulted in the need for additional surgical management. Medical records were reviewed for various demographic (e.g., age), clinical (e.g., organism), and surgical (e.g., presence of instrumentation) factors. A regression analysis was performed to identify what variables significantly increased the risk for SSI.

resultsDuring the 6-year period studied, a total of 74 patients met the inclusion criteria and were included in the study. There were 13 patients who failed medical management and required additional surgical management, which included irrigation and debridement. Thus, overall, medical management alone was effective in 82% of patients. In the final multivariate logistic regression analysis model, revision primary surgery had the strongest association with SSI that would require a washout. In addition, diabetes had a strong association with the occurrence of an infection.

conclusionsIdentification of risk factors associated with the need for additional surgical management may benefit from aggressive antibiotic therapy to reduce the likelihood of reoperation. Clinicians should be aware of the identified risk factors, which may help with postoperative management in at-risk individuals.

Indexed as

infectionirrigation and debridementlumbar surgerynonsurgical managementSSI

Identifiers

PMID31328087
PMCPMC6625706

What OpenQuestion holds

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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.