Lim S, et al. - Researchers herein looked at the risk factors, including both patient characteristics and perioperative factors, associated with postoperative infectious complications after single-level lumbar fusion (SLLF) surgery. Postoperative surgical site infection (SSI) was predicted by obesity, advanced American Society of Anesthesiologists classification, and longer operative time, as observed across a wide study population. Furthermore, factors that were found to be associated with non-SSI infectious complications after SLLF included increased age, female sex, serum creatinine more than 1.5 mg/dL, and prolonged operative duration.

• Using the American College of Surgeons National Surgical Quality Improvement Program database, researchers identified patients who underwent SLLF between 2006 and 2011.
• They carried out multivariate logistic regression analyses to identify pre- and intraoperative risk factors associated with postoperative infection.

• Researchers analyzed a total of 3353 patients.
• A postoperative infection was experienced by a total of 173 (5.2%) patients.
• Data showed 86 (2.6%) surgical site infections (SSIs) and 111 (3.3%) non-SSI infectious complications (pneumonia, urinary tract infection, sepsis/septic shock) were reported.
• Both SSI and non-SSI infectious complications were experienced by a total of 24 (0.7%) patients.
• The following factors were found to be associated with postoperative SSI: obesity (odds ratio [OR], 1.628; 95% confidence interval [CI], 1.042–2.544), American Society of Anesthesiologists class more than 2 (OR, 2.078; 95% CI, 1.309–3.299), and operative time more than 6 hours (OR, 2.573; 95% CI, 1.310–5.056).
• Researchers found that the following factors conferred risk for non-SSI infectious complications: age (60–69 yr; OR, 3.279; 95% CI, 1.541–6.980; and ≥70 yr; OR, 3.348; 95% CI, 1.519–7.378), female sex (OR, 1.791; 95% CI, 1.183–2.711), creatinine more than 1.5 mg/dL (OR, 2.400; 95% CI, 1.138–5.062), American Society of Anesthesiologists class more than 2 (OR, 1.835; 95% CI, 1.177–2.860), and operative time more than 6 hours (OR, 3.563; 95% CI, 2.082–6.097).