459 Association Between Vitamin D Deficiency and Surgical Site Infection Following Elective Lumbar Fusions. (1st April 2022)

• Record Type: Journal Article
• Authors: Planchard, Ryan F.; Alomari, Safwan; Azad, Tej D.; Feghali, James; Sciubba, Daniel M.; Witham, Timothy F.; Theodore, Nicholas; Bydon, Ali
• Is Part Of: Neurosurgery. Volume 68(2022)Supplement 1
• Page Start: 111
• Page End: 111
• Publication Date: 2022-04-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1227/NEU.0000000000001880_459
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : INTRODUCTION: Vitamin D deficiency has been associated with higher rates of SSI following a variety of surgical procedures. However, this association has been under-investigated for spinal procedures. METHODS: Patients who underwent lumbar fusions between 2011-2014 were reviewed from the HCUP-NIS database. Propensity score matching was utilized to minimize the effect of confounding variables between the 2 groups (normal vitamin D vs vitamin D deficiency). RESULTS: A total of 238, 875 cases of lumbar fusions met inclusion criteria for analysis. These included posterior/transforaminal lateral interbody fusions (PLIF/TLIF), Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). 22, 454 (9.4%) patients carried the diagnosis of vitamin D deficiency and were significantly more likely to be non-white (26.5% vs. 19.9%) and obese (21.1% vs. 15.4%) as compared to patients without deficiency. Other patient characteristics, socioeconomic factors, and hospital setting were comparable between two groups. SSI rates were compared between matched cohorts (18, 350 patients in each). In patients without vitamin D deficiency, there were 202 (1.1%) cases of SSI recorded, while there were 1266 (6.9%) cases of SSI recorded in patients with vitamin D deficiency (P<0.001). Patients with vitamin D deficiency had higher incidence of thromboembolic events (2.6% vs. 0.3%), length of hospital stay (5.7 vs. 3.4 days) as well as increased hospital charges (87, 812$ vs. 79, 650), (P <0.05). CONCLUSION: Optimizing preoperative vitamin D level could be potentially a cost-effective strategy to reduce the rate of SSI, thromboembolic events and prolonged hospital stay in patients undergoing lumbar fusion. Further cost-effectiveness analyses are encouraged to make definitive claims regarding pre-operative vitamin D screening/supplementation in these patients.