Incidence and Risk Factors of Surgical Site Infection Associated with Lumbar Spine Surgery in Upper Sindh

Abstract

Surgical site infections (SSIs) are a serious complication of lumbar spine surgery. This prospective study evaluated 600 patients undergoing lumbar spine procedures at a tertiary hospital in Upper Sindh (Jan 2018–Dec 2024). We determined the SSI incidence and analyzed patient and surgical factors associated with infection. Overall SSI incidence was 7.5% (45/600). Patients with SSIs were significantly older and had higher rates of obesity (BMI≥30), diabetes, and smoking. Univariate analysis showed that age, obesity, diabetes, smoking, longer operative time, and more  blood loss were associated with SSIs. Multivariate logistic regression identified the following independent risk factors: advanced age (OR=1.03 per year, 95% CI 1.01–1.05), obesity (OR=2.50, 95% CI 1.30–4.80), diabetes (OR=2.40, 95% CI 1.30–4.50), smoking (OR=2.10, 95% CI 1.10–4.20), increased operative time (OR=1.50 per hour, 95% CI 1.20–1.90), higher intraoperative blood loss (OR=1.002 per mL, 95% CI 1.001–1.003), and use of spinal implants (OR=3.00, 95% CI 1.20–7.50). These findings point out that modifiable patient factors (weight, glycemic control, smoking), perioperative management (minimizing surgery duration and blood loss), and proper post-operative care are critical to reducing SSI risk. Interventions targeting these factors may improve outcomes.