313 Impact of Intraoperative Steroids on Postoperative Infection Rates and Length of Hospital Stay: A Study of 1200 Spine Surgery Patients.

INTRODUCTION: The effects and use of intraoperative steroids is relatively unknown and remains controversial. There have been conflicting studies demonstrating the efficacy of intraoperative steroids on postoperative dysphagia and inflammation, whereas others demonstrate no improvement in outcomes. The aim of this study is to determine if the use of intraoperative steroids affects postoperative complications and length of hospital stay after spine surgery. METHODS: The medical records of 1200 adult (=18 years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were retrospectively reviewed. There were 495 (41.25%) patients who were administered intraoperative steroids, and 705 (58.75%) who were not (No-Steroid: n = 705; Steroid: n = 495). Patient demographics, comorbidities, and postoperative complication rates were collected on each patient. The primary outcomes investigated in this study were postoperative complications, specifically length of hospital stay and infection rates. RESULTS: Patient demographics were similar between both cohorts. The comorbidities were similar between the groups, with the intraoperative steroid use cohort having a higher number of chronic steroid users than the nonintraoperative steroid cohort (No-Steroid: 6.95 vs Steroid: 13.74, P = .001). Operative variables including length of operation and median number of fusion levels operated were also similar between both groups. Lumbar region was the most common surgical location. Patients who were administered intraoperative steroids had a shorter length of hospital stay by an average of 1 day (No-Steroid: 6.06 ± 6.76 days vs Steroid: 5.04 ± 4.86 days, P = .003), lower rates of urinary tract infections (No-Steroid: 10.37% vs Steroid: 6.88%, P = .0397) and other infection rates that were not deep or superficial surgical site infections (No-Steroid: 9.22% vs Steroid: 6.06%, P = .0460). CONCLUSION: Our study demonstrates that patients who receive intraoperative steroids have lower length of hospital days and infection rates after spine surgery. More studies are necessary to further understand the efficacy of intraoperative steroid use.

Duke Scholars

Author Oren N Gottfried Neurosurgery