Association between pressure ulcers and the risk of postoperative infections in male adults with spinal cord injury

Abstract

Objective

Data about postoperative infections in male adults with spinal cord injury are scarce. We aimed to evaluate the association between prior exposure to pressure ulcers (PU) and the risk of postoperative infections in male adults with spinal cord injury (SCI).

Methods

We conducted a prospective study of male adults receiving surgery of SCI from January 2007 to December 2019. Postoperative infection included septicemia, pneumonia, surgical incision infection and urinary tract infection. A logistic regression analysis was applied. Risk ratios (RRs) and their corresponding 95% confidence intervals (CIs) were calculated.

Results

There were 408 patients with SCI in this study, which comprised 204 patients with prior PU and 204 patients without. The rate of postoperative infections within 14 days in patients with PU was 23.5%, which was higher than that of patients without PU (6.9%). The amounts to a 4.18-folds elevated risk of any postoperative infections with 14 days in patients with PU (RR: 4.18, 95% CI: 2.30–7.60, p-value: <0.001). With respect to specific infections, positive associations in pneumonia (RR: 4.18, 95% CI: 2.30–7.60, p-value: <0.001), surgical incision infection (RR: 4.18, 95% CI: 2.30–7.60, p-value: <0.001), and urinary tract infection (RR: 4.18, 95% CI: 2.30–7.60, p-value: <0.001) were also statistically significant. These results did not materially alter adjustment for potential risk factors.

Conclusions

The study suggests an elevated risk of postoperative infections after surgery for SCI in male patients with prior exposure to pressure ulcers.

Keywords:

• Postoperative infection
• spinal cord injury
• pressure ulcer
• pneumonia

Disclosure statement

The authors declare no potential conflicts of interest relevant to this article.

Additional information

Funding

This study was funded by the Guizhou provincial Science & Technology Cooperation Program [Grant no. 2016LH7234], the Guizhou provincial Science Technology Fund Projects [Grant no. (2018)5779-7], Guizhou Provincial Natural Science Foundation [Grant no. QKH-J (2020)1Y323], the National Natural Science Foundation of China [Grant no. 81960234] and the Science and Technology Bureau of Guiyang [Grant no. (2018)1-88].