Do Preoperative Nasal Antiseptic Swabs Reduce the Rate of Surgical Site Infections After Adult Thoracolumbar Spine Surgery?
Bibliographic record
Abstract
INTRODUCTION: Surgical site infection (SSI) remains a major complication after adult spinal surgery. We investigated whether adding preoperative nasal decontamination by antiseptic swab (skin and nasal antiseptic povidone-iodine, SNA-PI) to our antimicrobial protocol reduces the SSI rate among our patients undergoing thoracolumbar spinal surgery. METHODS: We retrospectively reviewed all adult thoracolumbar spinal surgeries performed between June 2015 and May 2017 at a single hospital. Patients were divided into those who received nasal decontamination (SNA-PI+) and those who did not (SNA-PI-). SSI rates and responsible pathogens were compared between the cohorts. RESULTS: A total of 1,555 surgeries with nasal decontamination (SNA-PI+) and 1,423 surgeries without (SNA-PI-) were included. The SSI rate in the SNA-PI+ group was 13 of 1,555 (0.8%) versus 10 of 1,423 (0.7%) for SNA-PI- group (P = 0.68). The infection rate was the highest among posterior instrumented fusions in the SNA-PI+ group (1.4%). Methicillin-sensitive Staphylococcus aureus was responsible for 70% of infections in the SNA-PI- group and 38% in the SNA-PI+ group (P = 0.13). CONCLUSIONS: Routine nasal antiseptic swab before spine surgery did not affect the overall rate of SSI in thoracolumbar spinal surgeries. The incidence of methicillin-sensitive S aureus was lower in patients who received nasal decontamination (5/1,555, 0.3%) compared with those who did not (7/1,423, 0.5%); however, this result was not statistically significant (P = 0.57).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".