Risk factors and care of early surgical site infection after primary posterior lumbar interbody fusion

Abstract Objectives To explore the risk factors and nursing measures of early surgical site infection (SSI) after posterior lumbar interbody fusion (PLIF). Methods A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study. According to the occurrence of early SSI, the patients were divided into two groups, and the general data were analyzed by univariate analysis. Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures. Results Among 468 patients with PLIF, 18 patients developed early SSI (3.85%). The proportion of female, age, diabetes mellitus and urinary tract infection (UTI), operation segment, operation time, post-operative drainage volume, and drainage time were significantly higher than those in the uninfected group, with statistical significance (P < 0.05), whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group, with statistical significance (P < 0.05). There was no significant difference between the two groups in the American Society of Anesthesiologists (ASA) grading, body mass index (BMI), complications including cardiovascular and cerebrovascular diseases or hypertension (P > 0.05). Logistic regression analysis showed that preoperative diabetes mellitus (OR = 2.109, P = 0.012)/UTI (OR = 1.526, P = 0.035), prolonged drainage time (OR = 1.639, P = 0.029) were risk factors for early SSI. Men (OR = 0.736, P = 0.027) and albumin level (OR = 0.526, P = 0.004) were protective factors in reducing early SSI. Conclusions Women, preoperative diabetes/UTI, hypoproteinemia, and prolonged drainage time are risk factors for early SSI after PLIF. Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.