Extended Postoperative Antibiotic Prophylaxis Is Associated with No Clinical Value and Higher Projected Cost Following Adult Spinal Surgery: A Stratified Meta-Analysis and Probability-Based Cost Projections.

IF 1.7 Q2 SURGERY

JBJS Reviews Pub Date : 2024-09-03 eCollection Date: 2024-09-01 DOI:10.2106/JBJS.RVW.24.00068

Mohamed E Awad, Nicole A Griffin, Aaron B Epperson, Nicholas A Alfonso, David Ou-Yang

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引用次数: 0

Abstract

» We aimed to determine the cost-effectiveness of different protocols of extended postoperative antibiotic prophylaxis (E-PAP) following adult spinal surgery.

» Both stratified (randomized controlled trials only) and nonstratified (all studies) analyses demonstrated that E-PAP has no significant value in reducing the rate of surgical site infection (SSI), deep SSI, or superficial SSI.

» Notably, the E-PAP protocols were associated with a significant increase in the length of hospital stay, resulting in an additional expenditure of $244.4 per episode for the E-PAP 72 hours protocol compared with PAP 24 hours and $309.8 per episode for the E-PAP >48 hours protocol compared with PAP <48 hours.

» E-PAP does not demonstrate any significant reduction in the rate of SSIs following spine surgery. However, these extended protocols were significantly associated with an increase in the length of hospital stay and higher overall projected costs.

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成人脊柱手术后延长抗生素预防期无临床价值且预计成本较高：分层 Meta 分析和基于概率的成本预测。

"我们旨在确定成人脊柱手术后延长术后抗生素预防（E-PAP）的不同方案的成本效益"。分层（仅随机对照试验）和非分层（所有研究）分析表明，E-PAP 在降低手术部位感染 (SSI)、深部 SSI 或浅表 SSI 的发生率方面没有显著价值"。值得注意的是，E-PAP 方案与住院时间的显著延长有关，与 PAP 24 小时相比，E-PAP 72 小时方案导致每次住院额外支出 244.4 美元，与 PAP 24 小时相比，E-PAP >48 小时方案导致每次住院额外支出 309.8 美元。不过，这些延长方案与住院时间的延长和预计总费用的增加有明显关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JBJS Reviews SURGERY-

CiteScore

4.40

自引率

4.30%

发文量

132

期刊介绍： JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.