Risk and economic burden of surgical site infection following spinal fusion in adults.
Infect Control Hosp Epidemiol
; 44(1): 88-95, 2023 01.
Article
em En
| MEDLINE
| ID: mdl-35322778
ABSTRACT
BACKGROUND:
Spinal fusion surgery (SFS) is one of the most common operations in the United States, >450,000 SFSs are performed annually, incurring annual costs >$10 billion.OBJECTIVES:
We used a nationwide longitudinal database to accurately assess incidence and payments associated with management of postoperative infection following SFS.METHODS:
We conducted a retrospective, observational cohort analysis of 210,019 patients undergoing SFS from 2014 to 2018 using IBM MarketScan commercial and Medicaid-Medicare databases. We assessed rates of superficial/deep incisional SSIs, from 3 to 180 days after surgery using Cox proportional hazard regression models. To evaluate adjusted payments for patients with/without SSIs, adjusted for inflation to 2019 Consumer Price Index, we used generalized linear regression models with log-link and γ distribution.RESULTS:
Overall, 6.6% of patients experienced an SSI, 1.7% superficial SSIs and 4.9% deep-incisional SSIs, with a median of 44 days to presentation for superficial SSIs and 28 days for deep-incisional SSIs. Selective risk factors included surgical approach, admission type, payer, and higher comorbidity score. Postoperative incremental commercial payments for patients with superficial SSI were $20,800 at 6 months, $26,937 at 12 months, and $32,821 at 24 months; incremental payments for patients with deep-incisional SSI were $59,766 at 6 months, $74,875 at 12 months, and $93,741 at 24 months. Corresponding incremental Medicare payments for patients with superficial incisional at 6, 12, 24-months were $11,044, $17,967, and $24,096; while payments for patients with deep-infection were $48,662, $53,757, and $73,803 at 6, 12, 24-months.CONCLUSIONS:
We identified a 4.9% rate of deep infection following SFS, with substantial payer burden. The findings suggest that the implementation of robust evidence-based surgical-care bundles to mitigate postoperative SFS infection is warranted.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fusão Vertebral
/
Infecção da Ferida Cirúrgica
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Infect Control Hosp Epidemiol
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
ENFERMAGEM
/
EPIDEMIOLOGIA
/
HOSPITAIS
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos