Risk Factors of Clostridium Difficile Infection After Spinal Surgery: National Health Insurance Database

The purpose of this study was to evaluate risk factors of Clostridium Difficile infection (CDI) after spinal surgery using the Health Insurance Review and Assessment Service (HIRA) data. The incidence of postoperative CDI was investigated using HIRA data from 2012 to 2016. Cases involving CDI that o...

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Published inScientific reports Vol. 10; no. 1; p. 4438
Main Authors Sung, Sahyun, Kwon, Ji-Won, Lee, Soo-Bin, Lee, Hwan-Mo, Moon, Seong-Hwan, Lee, Byung Ho
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 10.03.2020
Nature Publishing Group
Subjects
692/1537/805
692/308/174
692/499
692/699/255/1911
Antibiotics
Back surgery
Cephalosporins
Clostridium
Humanities and Social Sciences
Infections
Mortality
multidisciplinary
Patients
Postoperative infection
Risk factors
Science
Science (multidisciplinary)
Surgery
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Summary:The purpose of this study was to evaluate risk factors of Clostridium Difficile infection (CDI) after spinal surgery using the Health Insurance Review and Assessment Service (HIRA) data. The incidence of postoperative CDI was investigated using HIRA data from 2012 to 2016. Cases involving CDI that occurred within a 30-day postoperative period were identified. Risk factors, including age, sex, comorbidities, postoperative infection, spinal surgery procedure, type of antibiotic, and duration of antibiotic use, were evaluated. Duration of hospital stay, medical cost, and mortality were also evaluated. In total, 71,322 patients were included. Presumed cases of CDI were identified in 57 patients, with CDI rate of 0.54 per 10,000 patient days. Advanced age, staged operation, postoperative infection, and the use of multiple antibiotics were significant risk factors. First-generation cephalosporins were shown to be associated with a lower incidence of CDI. CDI was also associated with longer hospital stays and increased medical cost, and it was an independent risk factor for increased mortality. Extra attention should be paid to patients at high risk for the development of postoperative CDI, and unnecessary use of multiple antibiotics should be avoided. Level of Evidence: Level III, retrospective cohort study
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ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-020-61327-1