게시판
| 21KS-037 |
Deep spinal infection following outpatient epidural injections for pain
서울대학교 의과대학 마취통증의학교실
Background: Deep spinal infection is a devastating complication after epidural injection. We aimed to investigate the incidence of deep spinal infection primarily after outpatient single-shot epidural injection for pain. Secondarily, we assessed the national trends of the procedure and risk factors for said infection.
Methods: Using South Korea’s National Health Insurance Service sample cohort database, the 10-year national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics.
Results: The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days post-procedurally (0.01% per injection). In multivariable analysis, age ≥65 years (odds ratio [OR], 2.91; 95% CI, 1.625; P = 0.001), living in a rural area (OR, 2.85; 95% CI, 1.57s (OR, 3.18; 95% CI, 1.30ple epidural injections (≥3 times) within the previous 90 days (OR, 2.34; 95% CI, 1.220.007), and recent use of immunosuppressants (OR, 2.90; 95% CI, 1.00ant risk factors of the infection post-procedurally.
Conclusion: The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making.
Methods: Using South Korea’s National Health Insurance Service sample cohort database, the 10-year national trend of single-shot epidural injections for pain and the incidence rate of deep spinal infection after the procedure with its risk factors were determined. New-onset deep spinal infections were defined as those occurring within 90 days of the most recent outpatient single-shot epidural injection for pain, needing hospitalization for at least 1 night, and receiving at least a 4-week course of antibiotics.
Results: The number of outpatient single-shot epidural injections per 1,000 persons in pain practice doubled from 40.8 in 2006 to 84.4 in 2015 in South Korea. Among the 501,509 injections performed between 2007 and 2015, 52 cases of deep spinal infections were detected within 90 days post-procedurally (0.01% per injection). In multivariable analysis, age ≥65 years (odds ratio [OR], 2.91; 95% CI, 1.625; P = 0.001), living in a rural area (OR, 2.85; 95% CI, 1.57s (OR, 3.18; 95% CI, 1.30ple epidural injections (≥3 times) within the previous 90 days (OR, 2.34; 95% CI, 1.220.007), and recent use of immunosuppressants (OR, 2.90; 95% CI, 1.00ant risk factors of the infection post-procedurally.
Conclusion: The incidence of deep spinal infection after outpatient single-shot epidural injections for pain is very rare within 90 days of the procedure (0.01%). The data identify high-risk patients and procedure characteristics that may inform healthcare provider decision-making.
