Spinal Level and Cord Involvement Predict Sepsis Following Vertebral Fracture Repair for Traumatic Spinal Injury

J Neurosurg Spine, 2022 · DOI: 10.3171/2021.12.SPINE21423 · Published: August 1, 2022

Simple Explanation

This study aimed to identify risk factors for sepsis in patients who underwent vertebral fracture repair for traumatic spinal injury. The study found that cervical spine fractures and spinal cord injuries, along with pre-existing conditions like diabetes and obesity, increase the risk of sepsis after surgery. Patients who developed sepsis had longer hospital stays and were more likely to be discharged to rehabilitative care or hospice.

Study Duration

2011-2014

Participants

30,463 adults undergoing vertebral fracture repair

Evidence Level

Not specified

Key Findings

1
Cervical spine injuries and spinal cord injuries are significantly associated with an increased risk of developing sepsis after vertebral fracture repair.
2
Pre-existing conditions such as diabetes and obesity increase the risk of sepsis.
3
Patients who developed sepsis experienced longer hospital stays and had a higher likelihood of adverse discharge outcomes, including discharge to rehabilitation or hospice.

Research Summary

This study identified risk factors for sepsis following vertebral fracture repair for traumatic spinal injury. Key risk factors include cervical spine injuries, spinal cord injuries, pre-existing comorbidities (diabetes, obesity), and severe concomitant injuries. Patients with sepsis had longer hospital stays and worse discharge outcomes, highlighting the clinical burden of this complication.

Practical Implications

Risk Stratification

Identify high-risk patients (cervical spine injuries, spinal cord injuries, comorbidities) for targeted sepsis prevention strategies.

Preventative Measures

Implement early detection and prevention protocols, especially for patients with identified risk factors.

Clinical Guidelines

Inform the development of evidence-based sepsis prevention guidelines specific to post-traumatic patients undergoing spinal repair.

Study Limitations

1
Underreporting of post-traumatic complications in the NTDB.
2
Inability to control for the severity and duration of septic episodes.
3
Lack of information regarding when sepsis arose during the hospitalization timeline.

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