Hannah Shelby, Tara Shelby, Zoe Fresquez, Jeffrey C Wang, Raymond Hah
{"title":"不同程度脊柱畸形关节融合术患者术后尿路感染的危险因素","authors":"Hannah Shelby, Tara Shelby, Zoe Fresquez, Jeffrey C Wang, Raymond Hah","doi":"10.14444/8724","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.</p><p><strong>Methods: </strong>Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. <i>χ</i> <sup>2</sup> tests were used for statistical analyses.</p><p><strong>Results: </strong>A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively (<i>P</i> = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: <i>P</i> = 0.005; <7 vs >12: <i>P</i> < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, <i>P</i> < 0.001; 7-12 OR = 2.1, <i>P</i> < 0.001; >12 OR = 2.3, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Postoperative Urinary Tract Infection in Patients Undergoing Arthrodesis for Spinal Deformity of Different Levels.\",\"authors\":\"Hannah Shelby, Tara Shelby, Zoe Fresquez, Jeffrey C Wang, Raymond Hah\",\"doi\":\"10.14444/8724\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.</p><p><strong>Methods: </strong>Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. <i>χ</i> <sup>2</sup> tests were used for statistical analyses.</p><p><strong>Results: </strong>A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively (<i>P</i> = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: <i>P</i> = 0.005; <7 vs >12: <i>P</i> < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, <i>P</i> < 0.001; 7-12 OR = 2.1, <i>P</i> < 0.001; >12 OR = 2.3, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.</p><p><strong>Level of evidence: 3: </strong></p>\",\"PeriodicalId\":38486,\"journal\":{\"name\":\"International Journal of Spine Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Spine Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14444/8724\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Spine Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14444/8724","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：虽然研究已经确定尿路感染（UTI）是脊柱融合后的并发症，但在脊柱畸形融合的背景下，尿路感染的研究还不够充分。本研究旨在确定脊柱畸形多节段后路融合术后UTI的发生率，以及综合危险因素（RFs）是否会增加UTI的风险。方法：从PearlDiver数据库中查询2010年至2019年间脊柱畸形后路融合术患者，按手术节段数（12）进行分类，年龄/性别匹配，分析1周内、1、2、3个月内UTI发生率。任何在手术前1年内有糖尿病、肥胖、类风湿关节炎或冠状动脉疾病记录的患者，在融合后1个月内感染尿路感染的患者都被纳入RF组。每个水平跨度有任何射频的患者与没有任何射频的患者进行比较。采用χ 2检验进行统计分析。结果：2010年至2019年，共有20,893例脊柱畸形患者接受了后路融合术。匹配后，每个水平集有2239例患者。在1、2、3个月时，>12水平亚组的UTI发生率高于7 ~ 12 (P = 0.41), >12水平亚组的UTI发生率为4.6% (P = 0.005；12: p < 0.001)。对于每个水平组，RF组在1、2和3个月时的UTI发生率显著较高。RF组各水平亚组的or值均显著大于1 (P < 0.001；7-12 or = 2.1, p < 0.001；>12 or = 2.3, p < 0.001)。结论：糖尿病、肥胖、类风湿关节炎和冠状动脉疾病与脊柱畸形后路融合术后尿路感染的高风险相关。接受超过12级手术的患者尿路感染的发生率最高。这是第一个分析和比较脊柱畸形融合术后尿路感染发生率的研究。证据等级：3；
Risk Factors for Postoperative Urinary Tract Infection in Patients Undergoing Arthrodesis for Spinal Deformity of Different Levels.
Background: While studies have identified urinary tract infection (UTI) as a complication after spine fusion, UTI is understudied in the context of fusion for spinal deformity. This study sought to determine both UTI incidence after multilevel posterior fusion for spinal deformity and whether pooled risk factors (RFs) increased UTI risk.
Methods: Patients who had posterior fusion for spinal deformities between 2010 to 2019 were queried from the PearlDiver database, separated by the number of levels operated on (<7, 7-12, and >12), matched for age/gender, and analyzed for UTI incidence within 1 week and 1, 2, and 3 months. Any patient with a note of diabetes, obesity, rheumatoid arthritis, or coronary artery disease within 1-year prior to surgery and who contracted UTI within 1 month after fusion was included in the RF group for each level span. Patients of each level span with any RF were compared with those without any RFs. χ2 tests were used for statistical analyses.
Results: A total of 20,893 patients underwent posterior fusion for spinal deformities from 2010 to 2019. After matching, each level set had 2239 patients. At 1, 2, and 3 months, the >12 levels subgroup showed statistically higher UTI incidence than the 7 to 12 and <7 levels subgroups. At 3 months, UTI was similar between the <7 and 7 to 12 subgroups, with 3.8% and 3.9%, respectively (P = 0.41), and UTI was statistically higher in the >12 subgroup at 4.6% (<7 vs 7-12: P = 0.005; <7 vs >12: P < 0.001). For each level group, the RF groups had significantly higher UTI rates at 1, 2, and 3 months. ORs were significantly greater than 1 for RF groups across all level subgroups (<7 OR = 2.8, P < 0.001; 7-12 OR = 2.1, P < 0.001; >12 OR = 2.3, P < 0.001).
Conclusions: Diabetes, obesity, rheumatoid arthritis, and coronary artery disease were associated with a higher risk of UTI after posterior fusion for spinal deformity for all level sets. patients who underwent procedures for more than 12 levels had the highest rate of UTI. This is the first study to analyze and compare UTI incidence following fusion for spinal deformity.
期刊介绍：
The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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