429 Service Evaluation of the Royal Orthopaedic Hospital Bone Infection Service in Patients with Spinal Infections, Both Native and Following Surgery - Five Years of Experience
R Nam, A Gardner, S Hughes, N Jenkins- Surgery
Abstract
Aim
The Royal Orthopaedic Hospital Bone Infection Service (ROH BIS) is one of the four formal bone infection services in the United Kingdom, providing multidisciplinary care and community support for patients with bone infection. This service evaluation is to document burden, pattern of infection and subsequent treatment by the ROH BIS in treating those with spinal infection, both native and following spinal surgery.
Method
This is a retrospective analysis of spinal infections treated from 2017-2022 at the ROH BIS. Clinical, MDT and investigation notes were reviewed for demographics, comorbidities and details of identification and management of the infection.
Results
39 patients (median age = 63, IQR = 34, male = 46.2%) were identified. 23 patients had previous metal implanted, 16 did not. The infection rate in ROH spinal surgery is 3%, 15 infections were native, and 24 were iatrogenic. Cardiovascular-related disease (38.5%) is the most common comorbidity. The mean time taken to identify a bone infection and infectious organism was 1.5 days and 4.0 days. Enterobacteriaceae (33.3%) and Staphylococcus Aureus (20.5%) were most commonly identified. Recurrent infection rate was 5.1%, and 5 (21.7%) cases required removal of implant. The mean number of MDT meetings for each patient is 1.7 meetings, and the mean extra hospital stay is 20 days.
Conclusions
Infections following spinal surgery are well managed by the multidisciplinary ROH BIS model. Rapid referral acceptance, strict diagnostic sampling criteria and specialised nursing care enabled precise management and lessened the burden of reoperation or metal implant removal on patients