Risk Factors for Surgical Site Infection in Orthopaedic Oncology. Issue 20 (15th October 2020)

• Record Type: Journal Article
• Authors: Anatone, Alex J.; Danford, Nicholas C.; Jang, Eugene S.; Smartt, Anne; Konigsberg, Matthew; Tyler, Wakenda K.
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 28:Issue 20(2020)
• Publication Date: 2020-10-15
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-19-00582
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : Introduction: Surgical site infections (SSIs) are common complications after surgeries involving musculoskeletal tumors, but we know little about SSI risk factors unique to orthopaedic oncology. A greater understanding of these factors will help risk-stratify patients and guide surgical decision-making. Methods: A retrospective review at a single-institution identified 757 procedures done on 624 over 6 years. The patients had a preoperative diagnosis of a malignant or potentially malignant neoplasm of the bone or soft tissues. Patient-specific and procedure-specific variables and diagnosis of SSI were recorded for each case. Data were analyzed through univariate analysis and multiple logistic regression. Results: On univariate analysis, significant patient-specific risk factors for SSI included malignancy ( P < 0.001), smoking history ( P = 0.041), and American Society of Anesthesiologists Score ( P = 0.002). Significant procedure-specific risk factors for SSI on univariate analysis included surgery time ( P < 0.001), estimated blood loss ( P < 0.001), blood transfusion volume ( P < 0.001), neoadjuvant chemotherapy ( P < 0.001), neoadjuvant radiation therapy ( P < 0.001), inpatient surgery ( P < 0.001), and number of previous surgeries within the study period ( P < 0.001). The two factors that independently predicted risk of SSI when controlling for all other variables in a multiple logistic regression were whether the surgery was done on an inpatient basis ( P = 0.005) and the number of previous surgeries done on the same site ( P = 0.001). Conclusions: We found a number of risk factors that correlate markedly with SSI after orthopaedic oncology surgery. The surgeon can use these risk factors to aid in surgical decision-making.