TY - JOUR T1 - Effects of Operating Room Size on Surgical Site Infection Following Lumbar Fusion Surgery JF - International Journal of Spine Surgery JO - Int J Spine Surg SP - 423 LP - 428 DO - 10.14444/6057 VL - 13 IS - 5 AU - HAROLD I. SALMONS AU - MAYAN LENDNER AU - SRIKANTH N. DIVI AU - MYLES DWORKIN AU - JAMES MCKENZIE AU - DANIEL TARAZONA AU - ZACHARY GALA AU - YOVEL LENDNER AU - BARRETT WOODS AU - DAVID KAYE AU - JASON SAVAGE AU - CHRISTOPHER KEPLER AU - MARK KURD AU - VICTOR HSU AU - KRIS RADCLIFF AU - JEFF RIHN AU - GREG ANDERSON AU - ALAN HILIBRAND AU - ALEX VACCARO AU - GREGORY SCHROEDER Y1 - 2019/10/01 UR - http://ijssurgery.com//content/13/5/423.abstract N2 - Background: Surgical site infections (SSIs) represent a devastating complication after spine surgery. Many factors have been identified, but the influence of operating room (OR) size on infection rate has not been assessed.Methods: Two thousand five hundred and twenty-three patients who underwent open lumbar spine fusion at a single institution between 2010 and 2016 were included. Patients were dichotomized into large versus small groups based on OR volume. Bivariate logistic regression and a final multivariate model following a multicollinearity check were used to calculate odds of infection for all variables.Results: A total of 63 patients (2.5%) developed SSIs with 46 (73%) in the larger OR group and 17 (27%) in the smaller OR group. The rate of SSIs in larger ORs was 3.02% compared with 1.81% in smaller ORs. Significant parameters impacting SSI in bivariate analysis included an earlier year of surgery, BMI > 30, more comorbidities, more levels decompressed and fused, smoking, and larger OR volumes. Multivariate analysis identified BMI > 30, Elixhauser scores, smoking, and increasing levels decompressed as significant predictors. Topical vancomycin was found to significantly decrease rate of infection in both analyses.Conclusions: OR size (large versus small) was ultimately not a significant predictor of infection related to rates of SSIs, although it did show a clinical trend toward significance, suggesting association. Future prospective analysis is warranted.Level of Evidence: 3. ER -