Risk of Complications in Spine Surgery: A Prospective Study

Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications.

Download Full-text

Incidence and modifiable risk factors of surveillance of surgical site infections in Egypt: A prospective study

American Journal of Infection Control ◽

10.1016/j.ajic.2011.07.001 ◽

2012 ◽

Vol 40 (5) ◽

pp. 426-430 ◽

Cited By ~ 10

Author(s):

Soad Hafez ◽

Tamer Saied ◽

Elham Hasan ◽

Manal Elnawasany ◽

Eman Ahmad ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Surgical Site Infections ◽

Modifiable Risk Factors ◽

A Prospective Study

Download Full-text

A Prospective Study in Primary Care in Patients Without Vascular Disease Comparing Levels of Coronary Risk Factors in Those Recommended for Lipid-Lowering Drugs Based on Either Absolute Risk or Absolute Risk Reduction

Preventive Cardiology ◽

10.1111/j.1520-037x.2003.00561.x ◽

2003 ◽

Vol 6 (1) ◽

pp. 17-21

Author(s):

Sud Ramachandran ◽

Peter Croft ◽

Richard H. Neary

Keyword(s):

Risk Factors ◽

Primary Care ◽

Prospective Study ◽

Vascular Disease ◽

Absolute Risk ◽

Absolute Risk Reduction ◽

Lipid Lowering ◽

Coronary Risk Factors ◽

Coronary Risk ◽

A Prospective Study

Download Full-text

Prevalence and Predictors of Depression after Stroke - Results from a Prospective Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.182 ◽

2018 ◽

Vol 6 (5) ◽

pp. 824-828 ◽

Cited By ~ 2

Author(s):

Danijela Vojtikiv-Samoilovska ◽

Anita Arsovska

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Activities Of Daily Living ◽

Prospective Study ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Daily Living ◽

Increased Risk ◽

The Right ◽

A Prospective Study

BACKGROUND: A depression following a stroke (Post Stoke Depression-PSD) is the most common complication of a stroke that has a negative effect on the result after the stroke. A better definition of the risk factors of the disease will provide for better prediction and treatment.AIM: To research identification of the risk factors for PSD, typical for the Macedonian population, which will help in early prediction, timely diagnosis and treatment of the disease?MATERIAL AND METHODS: We carried out a prospective study in order to determine the prevalence and the risk factors of PSD in 100 patients treated at the hospital in Tetovo. The severity, localisation and the functional outcome of the stroke have been examined as potential risk factors for discharge and after 5 months. The symptoms of depression were quantified using the Hamilton Depression Rating Scale (HAM-d).RESULTS: On discharge, 81% of the patients were diagnosed with PSD, and 67% had PSD after 5 months. A statistically significant codependence of p < 0.05 was registered between PSD and the level of functional dependence for activities of daily living (ADL); PSD and the severity of the stroke; and PSD and the level of disability on both examinations. In most patients with PSD, an ischemic stroke in the right middle cerebral artery has been diagnosed; the percentage difference between the other localisations is statistically significant (p = 0.0436; p = 0.0002).CONCLUSION: There is an increased risk of PSD for immobile patients, those incapable of activities of daily living (ADL), with ischemic stroke in the right middle cerebral artery. A PSD screening and additional studies for better prediction are required.

Download Full-text

Premonitory and Resolution Symptoms in Migraine: A Prospective Study in 100 Unselected Patients

Cephalalgia ◽

10.1111/j.1468-2982.2006.01157.x ◽

2006 ◽

Vol 26 (9) ◽

pp. 1051-1060 ◽

Cited By ~ 94

Author(s):

E Quintela ◽

J Castillo ◽

P Muñoz ◽

J Pascual

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Migraine With Aura ◽

Severe Pain ◽

Disability Assessment ◽

General Physician ◽

Assessment Scores ◽

The Mean ◽

A Prospective Study

The nosology of migraine premonitory (PS) and resolution (RS) symptoms was studied in 100 migraineurs consulting their general physician. They were asked to fill in, for three attacks, a PS and RS questionnaire. ‘True’ PS/RS were those experienced the day before (or the day after) the headache had started only if they were not present in a questionnaire completed in a pain-free period. True PS and RS were experienced by 84± and 80±, respectively, of subjects for the first attack. The mean and range (per patient) of PS were 6.8 and 0–21 and of RS 4.7 and 0–15. Anxiety, phonophobia, irritability, unhappiness and yawning were the commonest PS, whereas asthenia, tiredness, somnolence and concentration difficulties were the most common RS. Gender, age and Migraine Disability Assessment scores did not influence PS and RS. Both PS and RS were more frequent in migraine with aura subjects. Patients on preventatives showed a decreased frequency of PS and, to a lesser degree, of RS. Severity of headache was associated with a higher frequency of RS. Individual RS and especially PS were quite consistent after three attacks. Almost two-thirds of the symptoms were noticed in at least two out of three attacks, while more than a half of PS and more than a quarter of RS repeated in three out of three attacks. In conclusion, around 80± of unselected migraineurs experience RS and PS. Migraine with aura and severe pain are risk factors for experiencing PS and RS, while preventatives were protective, especially for PS.

Download Full-text

Antimicrobial prophylaxis in noninstrumented spine surgery: a prospective study to determine efficacy and drawbacks

Journal of Neurosurgery Spine ◽

10.3171/2020.11.spine201891 ◽

2021 ◽

pp. 1-10

Author(s):

Aymeric Amelot ◽

Maximilien Riche ◽

Samuel Latreille ◽

Vincent Degos ◽

Alexandre Carpentier ◽

...

Keyword(s):

Risk Factors ◽

Single Dose ◽

Prospective Study ◽

Antibiotic Prophylaxis ◽

Spine Surgery ◽

Surgical Site Infections ◽

Csf Leak ◽

Resistant Bacteria ◽

Group A ◽

Group B

OBJECTIVE The authors sought to evaluate the roles of perioperative antibiotic prophylaxis in noninstrumented spine surgery (NISS), both in postoperative infections and the impact on the selection of resistant bacteria. To the authors’ knowledge, only one prospective study recommending preoperative intravenous (IV) antibiotics for prophylaxis has been published previously. METHODS Two successive prospective IV antibiotic prophylaxis protocols were used: from 2011 to 2013 (group A: no prophylactic antibiotic) and from 2014 to 2016 (group B: prophylactic cefazolin). Patient infection rates, infection risk factors, and bacteriological status were determined. RESULTS In total, 2250 patients (1031 in group A and 1219 in group B) were followed for at least 1 year. The authors identified 72 surgical site infections, 51 in group A (4.9%) and 21 in group B (1.7%) (p < 0.0001). A multiple logistic regression hazard model identified male sex (HR 2.028, 95% CI 1.173–3.509; p = 0.011), cervical laminectomy (HR 2.078, 95% CI 1.147–3.762; p = 0.016), and postoperative CSF leak (HR 43.782, 95% CI 10.9–189.9; p < 0.0001) as independent predictive risk factors of infection. In addition, preoperative antibiotic prophylaxis was the only independent favorable factor (HR 0.283, 95% CI 0.164–0.488; p < 0.0001) that significantly reduced infections for NISS. Of 97 bacterial infections, cefazolin-resistant bacteria were identified in 26 (26.8%), with significantly more in group B (40%) than in group A (20.9%) (p = 0.02). CONCLUSIONS A single dose of preoperative cefazolin is effective and mandatory in preventing surgical site infections in NISS. Single-dose antibiotic prophylaxis has an immediate impact on cutaneous flora by increasing cefazolin-resistant bacteria.

Download Full-text

A prospective study of surgical site infections in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20172109 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1945

Author(s):

Chenna Krishna Reddy Chada ◽

Jithendra Kandati ◽

Munilakshmi Ponugoti

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Prospective Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Surgical Site Infections ◽

Care Hospital ◽

A Prospective Study

Background: Among the Health care associated infections (HAI), surgical site infections (SSI) previously termed as post-operative wound infections are one of the most common HAI in low and middle income countries. Increase in SSI is associated with increased morbidity, as well as mortality due to emergence of antimicrobial resistant pathogens. Understanding the pathogens implicated in causing the SSIs and their antimicrobial sensitivity place a good role in reducing the mortality and morbidity.Methods: A prospective study was conducted at a tertiary care hospital to all the patients admitted in Department of surgery, Orthopedics and Gynecology and Obstetrics for six months from January 2016 to June 2016. The demographic data, inclusion criteria and exclusion criteria, risk factors, clinical history, laboratory data with gram stain, culture results and antibiotic sensitivity of the isolates were collected.Results: Two hundred patients were recruited in the study and the prevalence of SSI in the study was 3.83%. Patients who underwent emergency operations and diabetics were at higher risk of acquiring SSI. The most commonly isolated pathogens in the study were Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Pseudomonas aeruginosa was most common isolate from orthopedic cases of SSI, Escherichia coli was most common isolate from intestinal surgeries and Staphylococcus aureus from LSCS. Increased rate of isolation of MRSA and ESBL strains were observed in the study.Conclusions: Study clearly explains the various causes and risk factors associated in development of SSI. The study guides in the type of the organism isolated and possible antibiotic of choice in treatment and management of SSI. The prevalence of SSI was 3.83%, which is comparable with some of the studies and lower than many of the studies.

Download Full-text

Cold Weather Training: A Risk Factor for Achilles Paratendinitis among Recruits

Foot & Ankle International ◽

10.1177/107110070302400504 ◽

2003 ◽

Vol 24 (5) ◽

pp. 398-401 ◽

Cited By ~ 29

Author(s):

C. Milgrom ◽

A. Finestone ◽

D. Zin ◽

D. Mandel ◽

V. Novack

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Prospective Study ◽

Achilles Tendinopathy ◽

Cold Weather ◽

Increased Risk ◽

A Prospective Study ◽

Outdoor Training

In a prospective study of risk factors for Achilles tendinopathy among four induction cycles of infantry recruits, 95 out of 1405 recruits, (6.8%) were found to suffer from Achilles tendinopathy. In more than 94% of the cases, the tendinopathy was considered to be paratendinitis. Training season had a statistically significant effect on the incidence of Achilles paratendinitis with 3.6% suffering in the summer and 9.4% in the winter ( p = .001). This increased risk for Achilles paratendinitis in cold weather outdoor training can be explained by a fall in temperature of the Achilles paratenon whose membranes are rich in mucopolysaccharides and serve as a lubricant for gliding of the tendon and epitenon. Decreased temperature may increase the viscosity of the lubricant and thereby increases friction and risk for Achilles paratendinitis. This same relationship illustrates why “warming up” before exercising may be important in lowering the incidence of Achilles paratendinitis.

Download Full-text

ORGANIZATION OF EPIDEMIOLOGICAL SURVEILLANCE OF INFECTIONS IN THE FIELD OF SURGICAL INTERVENTION

ЗДОРОВЬЕ НАСЕЛЕНИЯ И СРЕДА ОБИТАНИЯ - ЗНиСО / PUBLIC HEALTH AND LIFE ENVIRONMENT ◽

10.35627/2219-5238/2018-303-6-45-48 ◽

2018 ◽

pp. 45-48

Author(s):

O.A. Orlova ◽

V.G. Akimkin

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Surgical Intervention ◽

Surgical Site Infections ◽

Epidemiological Surveillance ◽

Healthcare Associated Infections ◽

The World ◽

Correct Calculation ◽

A Prospective Study ◽

Healthcare Associated

Surgical site infections (SSI) are the most common and most expensive of the Healthcare-associated Infections (HAI). The rate of SSI in the world is 11.2 per 100 patients. One of the significant and important factors leading to ineffectiveness of prevention of SSI is a weak system of epidemiological surveillance, including insufficient completeness of accounting and registration of Healthcare-associated Infections. To conduct a full epidemiological surveillance of SSI, the complex of measures is necessary, including: conducting a prospective study, efficient microbiological monitoring of SSI pathogens, correct calculation of morbidity taking into account risk factors, organizational-methodical support of epidemiological surveillance.

Download Full-text