Is a Pre-Operative UTI a Risk Factor for Post-Operative Wound Infection After Spinal Fusion?

Abstract

Research Question: Is a pre-operative Urinary Tract Infection (UTI) a risk factor for post-operative wound infection after spinal fusion?

Background and Significance: Spine surgery is a prevalent elective operation in the United States with the possibility of wound infection complications, and preoperatively, UTIs are common healthcare infections. Based on our review of current literature, very little evidence exists on the relationship between a positive pre-operative urinary tract infection and post-operative surgical site infections in patients undergoing spinal fusions. The purpose of this study is to evaluate the association between pre-operative urinary tract infections and post-operative surgical site infections within 30 days post operation.

Materials and Methods: Following institutional review board (IRB) approval, this retrospective study examined 1,061 adult patients undergoing spinal fusions at a single high-volume center between 2019 and 2020. Patient clinical data such as principal diagnosis, presence of preoperative UTI, length of stay, readmission within thirty days, and the presence of wound infections was collected. Available data from patients’ electronic medical record was reviewed. Statistical Package for Social Sciences (SPSS) was used to perform independent sample t-tests to analyze numeric data and to perform Chi square tests of independence to analyze categorical data.

Results: The incidence of pre-operative urinary tract infections was 7.5%, and the incidence of post-operative surgical site infections was 1.9%. Patients with a pre-operative urinary tract infection did not have a statistically significant increase in their risk of a developing surgical site infections after undergoing spinal fusion (p = 0.674).

Conclusion: Our findings suggest that individuals with pre-operative urinary tract infections in the absence of bacteremia or sepsis may not benefit from postponing their spinal surgeries. However, prompt treatment with appropriate antibiotics is warranted.