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Atkinson, Ross A.; Davies, Benjamin; Jones, Anna; Van Popta, Dmitri; Ousey, Karen; Stephenson, John (2016)
Publisher: Elsevier
Languages: English
Types: Article
Subjects: R1
Summary\ud Background\ud Patients with metastatic spinal tumours have a limited prognosis. Surgical complications that may result in prolonged hospitalization or readmission are highly undesirable. Surgical site infection (SSI) is one such complication, which can, in extreme cases, lead to death.\ud \ud Aim\ud To assess the impact of SSI on patient survival after surgery for spinal metastases.\ud \ud Methods\ud Demographic, operative, and survival data were collected on 152 patients undergoing surgery for spinal metastasis at a large UK tertiary referral centre. American Society of Anesthesiologists (ASA) grade and the Revised Tokuhashi Score (RTS) were determined as measures of health status and prognosis, respectively, at baseline. A semi-parametric Cox proportional hazards survival analysis was used to assess the relationships between covariates and survival.\ud \ud Findings\ud Seventeen patients (11.2%) experienced SSI. Overall, median survival time from operation was 262 days (95% confidence interval: 190–334 days) and 12-month survival was 42.1%. RTS (hazard ratio: 0.82; 95% confidence interval: 0.76–0.89; P < 0.001) and ASA grade (1.37; 1.03–1.82; P = 0.028) were significantly associated with survival, with better survival found in patients with higher RTS and lower ASA scores. Infection status was of substantive importance, with better survival in those without SSI (P = 0.075).\ud \ud Conclusion\ud Twelve-month survival in patients undergoing surgery for spinal metastasis is ∼42%. RTS and ASA scores may be used as indicators of patient survival either in combination or individually. Whereas SSI has some negative impact on survival, a larger study sample would be needed to confirm whether this is statistically significant
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    • NICE, Metastatic spinal cord compression: diagnosis and management of patients at risk of or with metastatic spinal cord compression. 2008, National Collaborating Centre for Cancer: Cardiff.
    • Klimo P, Jr. and Schmidt MH. Surgical management of spinal metastases. Oncologist, 2004.
    • 9(2): p. 188-96.
    • Cancer Control, 2012. 19(2): p. 122-8.
    • Urban JA. Cost analysis of surgical site infections. Surg Infect (Larchmt), 2006. 7 Suppl 1: p.
    • S19-22.
    • Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE and Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol, 1999. 20(11): p. 725-30.
    • Tokuhashi Y, Matsuzaki H, Oda H, Oshima M and Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976), 2005.
    • 30(19): p. 2186-91.
    • Dripps RD, Lamont A and Eckenhoff JE. The role of anesthesia in surgical mortality. JAMA, 1961. 178: p. 261-6.
    • Atkinson RA, Stephenson J, Jones A and Ousey KJ. An assessment of key risk factors for surgical site infection in patients undergoing surgery for spinal metastases. Journal of Wound Care, 2016. In Press.
    • PHE, Protocol for the surveillance of surgical site infection: surgical site infection surveillance service. 2013, Public Health England: London.
    • Horan TC, Gaynes RP, Martone WJ, Jarvis WR and Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections.
    • Infect Control Hosp Epidemiol, 1992. 13(10): p. 606-8.
    • Boogerd W and van der Sande JJ. Diagnosis and treatment of spinal cord compression in malignant disease. Cancer Treat Rev, 1993. 19(2): p. 129-50.
    • Moon KY, Chung CK, Jahng TA, Kim HJ and Kim CH. Postoperative survival and ambulatory outcome in metastatic spinal tumors : prognostic factor analysis. J Korean Neurosurg Soc, 2011. 50(3): p. 216-23.
    • Astagneau P, Rioux C, Golliot F, Brucker G and Group INS. Morbidity and mortality associated with surgical site infections: results from the 1997-1999 INCISO surveillance. J Hosp Infect, 2001. 48(4): p. 267-74.
    • Awad SS. Adherence to surgical care improvement project measures and post-operative surgical site infections. Surg Infect (Larchmt), 2012. 13(4): p. 234-7.
    • Coello R, Charlett A, Wilson J, et al. Adverse impact of surgical site infections in English hospitals. J Hosp Infect, 2005. 60(2): p. 93-103.
    • Humphreys H. Preventing surgical site infection. Where now? J Hosp Infect, 2009. 73(4): p.
    • Crolla RM, van der Laan L, Veen EJ, et al. Reduction of surgical site infections after implementation of a bundle of care. PLoS One, 2012. 7(9): p. e44599.
    • Johnson B, Starks I, Bancroft G and Roberts PJ. The effect of care bundle development on surgical site infection after hemiarthroplasty: an 8-year review. J Trauma Acute Care Surg, 2012. 72(5): p. 1375-9.
    • Nielsen PR, Jorgensen LD, Dahl B, Pedersen T and Tonnesen H. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial. Clin Rehabil, 2010. 24(2): p. 137- 48.
    • Olsen MA, Nepple JJ, Riew KD, et al. Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am, 2008. 90(1): p. 62-9.
    • Demura S, Kawahara N, Murakami H, et al. Surgical site infection in spinal metastasis: risk factors and countermeasures. Spine (Phila Pa 1976), 2009. 34(6): p. 635-9.
    • Tanner J, Padley W, Davey S, Murphy K and Brown B. Patient narratives of surgical site infection: implications for practice. J Hosp Infect, 2013. 83(1): p. 41-5.
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