Does Intraoperative Forced-Air Warming Increase the Risk of Surgical Site Infections After Spine Surgery?: A Propensity Score-Matched Analysis.

Abstract

A retrospective cohort study with propensity score matching. To compare the incidence of surgical site infection (SSI) between spine surgeries with and without intraoperative use of forced-air warming (FAW). No study has investigated whether intraoperative FAW increase SSI following spine surgery. This study analyzed 245 patients who underwent spine surgery. Baseline characteristics such as age, gender, body mass index, the American Society of Anesthesiologists Physical Status (ASA-PS), diagnosis of diabetes mellitus, and current smoking habits were investigated. Surgical data such as operative site, previous spine surgery at the same site, operative time, intraoperative blood loss, and use of spinal instrumentation were evaluated. Patients were divided into 2 groups based on the use of FAW. The baseline characteristics, surgical data, and incidence of SSI were compared between the 2 groups. To estimate the incidence of SSI without biases due to various confounding factors, a propensity score pairwise matching was performed. The FAW was used in 45 patients, while 200 patients underwent surgery without the use of the FAW. The incidence of SSI was not significantly higher in patients with FAW (8.9%) compared with those without FAW (3.0%) (P=0.07). Patients with FAW exhibited significantly higher ASA-PS, longer operative times, greater intraoperative blood loss, and a higher rate of instrumentation use compared with those without FAW (P<0.01). After propensity score matching, which yielded 39 pairs of patients, the incidence of SSI was no significant difference between patients with (10.3%) and without FAW (7.7%) (P=0.69). In 39 pairs of propensity matched patients, the use of FAW was not associated with an increased risk of SSI in spine surgery.