Cost and quality of life outcome analysis of postoperative infections after posterior lumbar decompression and fusion

•Surgical site infections produce no long-term differences in quality of life.•Surgical site infections associated with roughly $21,000 cost increase per case.•Surgical site infections render lumbar decompression cost ineffective. Surgical site infections (SSI) following spine procedures are serious...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2019-10, Vol.68, p.105-110
Main Authors: Pennington, Zach, Sundar, Swetha J., Lubelski, Daniel, Alvin, Matthew D., Benzel, Edward C., Mroz, Thomas E.
Format: Article
Language:English
Subjects:
Cost effectiveness
Lumbar fusion
Outcomes
Postoperative infection
Quality of life
Wound infection
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Summary:•Surgical site infections produce no long-term differences in quality of life.•Surgical site infections associated with roughly $21,000 cost increase per case.•Surgical site infections render lumbar decompression cost ineffective. Surgical site infections (SSI) following spine procedures are serious and costly complications that may reduce patient quality of life (QOL). Deep SSIs may also extend hospitalizations and require surgical debridement or antibiotic therapy, increasing costs to both patients and the healthcare system. Here we sought to evaluate the effect of deep SSI on care cost and QOL outcomes in patients undergoing posterior lumbar decompression and fusion. To do so we performed a retrospective study of patients undergoing lumbar decompression and fusion between 2008 and 2012. Patients experiencing postoperative deep SSI were matched to controls not experiencing a deep SSI. Included patients had prospectively-gathered QOL outcome measures collected preoperatively and at 6 months postoperatively. Health resource utilization was recorded from patient electronic medical records over the 6-month follow-up. Direct costs were estimated using Medicare national payment amounts. Indirect costs were based on missed work days and patient income. We found both cohorts experienced significant improvements in QOL scores following surgery, and there were no significant differences between the cohorts. The average total cost was significantly higher in the infected cohort compared to controls ($37,009 vs. $16,227; p 
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2019.07.025