[Analysis of risk factors of postoperative wound infection in lumbar spondylolisthesis]

Objective: To explore related risk factors of postoperative wound infection in lumbar spondylolisthesis.

Methods: The clinical data of 296 patients with lumbar spondylolisthesis underwent posterior decompression and fusion from January 2013 to December 2017 were retrospectively analyzed. According to whether the wound was infected or not, the patients were divided into infection group and non-infection group. There were 29 patients in infection group including 13 males and 16 females with an average age of(67.03±1.01) years old and 267 patients in non-infection group including 91 males and 176 females with an average age of (52.32±16.08) years old. Gender, age, body mass index (BMI), smoking history, diabetes history, hormone use history, albumin level, operation time, ASA score, perioperative blood transfusion and drainage time were recorded. The multivariate Logistic regression analysis was carried out if univariate Logistic regression analysis of risk factors were statistical significant. At the same time the SPSS decision tree model was used to determine the stratified points of the continuous variables to further specify the independent risk factors.

Results: Postoperative wound infection occurred in 29 cases among all patients, with the incidence rate of 9.8% (29/296). There were significant differences in BMI, age, diabetes history, drainage time, hormone use history, albumin level and operation time between two groups(P<0.05). After excluding mutual infection among these factors by univariate Logistic regression analysis, results showed obesity, age, diabetes history, hormone use history, operation time, drainage time may be risk factors for wound infection after lumbar spondylolisthesis surgery. By multivariate Logistic regression analysis of possible risk factors, results showed age, diabetes history, hormone use history and drainage time were independent risk factors for wound infection after operation.

Conclusions: Age, diabetes history, hormone use history and drainage time are independent risk factors for postoperative wound infection. Age more than or equal to 64 years old, drainage tube retention time more than 48 h, complicated with diabetes mellitus and hormone use are high risk factors for postoperative wound infection.

Keywords: Lumbar spondylolisthesis; Postoperative wound infection; Risk factor.