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Surgical Site Infection Risk Elevated in Certain Patients

In spinal surgery patients, risk is higher in those with diabetes, hyperglycemia and obesity

THURSDAY, Jan. 10 (HealthDay News) -- In patients who undergo spinal surgery, the risk of surgical site infection is increased in those with diabetes or an elevated preoperative or postoperative serum glucose level, according to study findings published in the January issue of the Journal of Bone and Joint Surgery.

In a retrospective case-control study, Margaret A. Olsen, Ph.D., of the Washington University School of Medicine in St. Louis, and colleagues compared 46 spinal surgery patients who developed a superficial, deep or organ-space surgical site infection with 227 uninfected spinal-surgery patients (controls).

The researchers found that serum glucose levels, preoperatively and within five days after the operation, were significantly higher in patients who developed an infection than in uninfected controls. They determined that the independent risk factors for surgical site infections included diabetes (odds ratio 3.5), suboptimal timing of prophylactic antibiotic therapy (OR, 3.4), a preoperative serum glucose level of greater than 125 mg/dL or a postoperative serum glucose level of greater than 200 mg/dL (OR, 3.3) and obesity (OR, 2.2).

"The role of hyperglycemia as a risk factor for surgical site infection in patients not previously diagnosed with diabetes should be investigated further," the authors conclude. "Administration of prophylactic antibiotics within one hour before the operation and increasing the antibiotic dosage to adjust for obesity are also important strategies to decrease the risk of surgical site infection after spinal operations."

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