Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction
Objective: Postoperative lymphopenia is reported as an excellent indicator to predict surgical-site infection (SSI) after spine surgery. However, there is still controversy concerning which serological markers can predict spinal SSI. This study aims to evaluate excellent and early indicators for det...
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MDPI AG
2024-12-01
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| author | Akiyoshi Miyamoto Masato Tanaka Angel Oscar Paz Flores Dongwoo Yu Mukul Jain Christan Heng Tadashi Komatsubara Shinya Arataki Yoshiaki Oda Kensuke Shinohara Koji Uotani |
| author_facet | Akiyoshi Miyamoto Masato Tanaka Angel Oscar Paz Flores Dongwoo Yu Mukul Jain Christan Heng Tadashi Komatsubara Shinya Arataki Yoshiaki Oda Kensuke Shinohara Koji Uotani |
| author_sort | Akiyoshi Miyamoto |
| collection | DOAJ |
| description | Objective: Postoperative lymphopenia is reported as an excellent indicator to predict surgical-site infection (SSI) after spine surgery. However, there is still controversy concerning which serological markers can predict spinal SSI. This study aims to evaluate excellent and early indicators for detecting SSI, focusing on spine instrumented surgery. Materials and Methods: This study included 268 patients who underwent spinal instrumented surgery from January 2022 to December 2023 (159 female and 109 male, average 62.9 years). The SSI group included 20 patients, and the non-SSI group comprised 248 patients. Surgical time, intraoperative blood loss, and glycemic levels were measured in both groups. The complete blood cell counts, differential counts, albumin, and C-reactive protein (CRP) levels were measured pre-surgery and postoperative on Days 1, 3, and 7. In comparing the groups, the Mann–Whitney U test analysis was used for continuous variables, while the chi-squared test and Fisher’s exact test were used for dichotomous variables. Results: The incidence of SSI after spinal instrumentation was 7.46% and was relatively higher in scoliosis surgery. The SSI group had significantly longer surgical times (248 min vs. 180 min, <i>p</i> = 0.0004) and a higher intraoperative blood loss (772 mL vs. 372 mL, <i>p</i> < 0.0001) than the non-SSI group. In the SSI group, the Day 3 (10.5 ± 6.2% vs. 13.8 ± 6.0%, <i>p</i> = 0.012) and Day 7 (14.4 ± 4.8% vs. 18.8 ± 7.1%, <i>p</i> = 0.012) lymphocyte ratios were lower than the non-SSI group. Albumin levels on Day 1 in the SSI group were lower than in the non-SSI group (2.94 ± 0.30 mg/dL vs. 3.09 ± 0.38 mg/dL, <i>p</i> = 0.045). There is no difference in CRP and lymphocyte count between the two groups. Conclusions: SSI patients had lower lymphocyte percentages than non-SSI patients, which was a risk factor for SSI, with constant high inflammation. The Day 3 lymphocyte percentage may predict SSI after spinal instrumented surgery. |
| format | Article |
| id | doaj-art-25f1920a7a2549dd97c607138ed6bab2 |
| institution | OA Journals |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-25f1920a7a2549dd97c607138ed6bab22025-08-20T01:55:38ZengMDPI AGDiagnostics2075-44182024-12-011423271510.3390/diagnostics14232715Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte ReductionAkiyoshi Miyamoto0Masato Tanaka1Angel Oscar Paz Flores2Dongwoo Yu3Mukul Jain4Christan Heng5Tadashi Komatsubara6Shinya Arataki7Yoshiaki Oda8Kensuke Shinohara9Koji Uotani10Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, JapanDepartment of Orthopedic Surgery, Okayama University Hospital, Okayama 700-8558, JapanDepartment of Orthopedic Surgery, Okayama University Hospital, Okayama 700-8558, JapanDepartment of Orthopedic Surgery, Okayama University Hospital, Okayama 700-8558, JapanObjective: Postoperative lymphopenia is reported as an excellent indicator to predict surgical-site infection (SSI) after spine surgery. However, there is still controversy concerning which serological markers can predict spinal SSI. This study aims to evaluate excellent and early indicators for detecting SSI, focusing on spine instrumented surgery. Materials and Methods: This study included 268 patients who underwent spinal instrumented surgery from January 2022 to December 2023 (159 female and 109 male, average 62.9 years). The SSI group included 20 patients, and the non-SSI group comprised 248 patients. Surgical time, intraoperative blood loss, and glycemic levels were measured in both groups. The complete blood cell counts, differential counts, albumin, and C-reactive protein (CRP) levels were measured pre-surgery and postoperative on Days 1, 3, and 7. In comparing the groups, the Mann–Whitney U test analysis was used for continuous variables, while the chi-squared test and Fisher’s exact test were used for dichotomous variables. Results: The incidence of SSI after spinal instrumentation was 7.46% and was relatively higher in scoliosis surgery. The SSI group had significantly longer surgical times (248 min vs. 180 min, <i>p</i> = 0.0004) and a higher intraoperative blood loss (772 mL vs. 372 mL, <i>p</i> < 0.0001) than the non-SSI group. In the SSI group, the Day 3 (10.5 ± 6.2% vs. 13.8 ± 6.0%, <i>p</i> = 0.012) and Day 7 (14.4 ± 4.8% vs. 18.8 ± 7.1%, <i>p</i> = 0.012) lymphocyte ratios were lower than the non-SSI group. Albumin levels on Day 1 in the SSI group were lower than in the non-SSI group (2.94 ± 0.30 mg/dL vs. 3.09 ± 0.38 mg/dL, <i>p</i> = 0.045). There is no difference in CRP and lymphocyte count between the two groups. Conclusions: SSI patients had lower lymphocyte percentages than non-SSI patients, which was a risk factor for SSI, with constant high inflammation. The Day 3 lymphocyte percentage may predict SSI after spinal instrumented surgery.https://www.mdpi.com/2075-4418/14/23/2715surgical site infectionspine surgeryinstrumentationdiagnosislymphocyte |
| spellingShingle | Akiyoshi Miyamoto Masato Tanaka Angel Oscar Paz Flores Dongwoo Yu Mukul Jain Christan Heng Tadashi Komatsubara Shinya Arataki Yoshiaki Oda Kensuke Shinohara Koji Uotani Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction Diagnostics surgical site infection spine surgery instrumentation diagnosis lymphocyte |
| title | Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction |
| title_full | Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction |
| title_fullStr | Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction |
| title_full_unstemmed | Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction |
| title_short | Predicting Surgical Site Infections in Spine Surgery: Association of Postoperative Lymphocyte Reduction |
| title_sort | predicting surgical site infections in spine surgery association of postoperative lymphocyte reduction |
| topic | surgical site infection spine surgery instrumentation diagnosis lymphocyte |
| url | https://www.mdpi.com/2075-4418/14/23/2715 |
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