Climatic and Clinical Risk Factors for Surgical Site Infection Following Spine Fusion Surgery: A Large-Scale Big Data Analysis

Purpose This study aimed to identify both clinical and meteorological risk factors for surgical site infection (SSI) following spine fusion surgery (SFS), with a focus on integrating medical big data and weather data. Methods We retrospectively analyzed data from 10,880 patients who underwent SFS between January 2013 and November 2022 at eight university-affiliated hospitals. Clinical data were sourced from the Catholic Medical Center Clinical Data Warehouse, and regional meteorological data were obtained from the Korea Meteorological Administration. SSI was defined based on diagnostic codes and antibiotic prescriptions within three months postoperatively. Risk factors were assessed using logistic regression and correlation analyses. Results The overall SSI incidence was 4.66% (507 cases). Significant clinical risk factors included older age, severe obesity (BMI ≥ 35), longer operative time, and higher intraoperative transfusion volume. Surgeries conducted on Wednesdays were associated with a lower SSI risk. While seasonal variation was not statistically significant, SSIs were relatively less common in January and February. Climatic factors, including higher average temperature and humidity during the first postoperative week, were moderately correlated with increased SSI risk (temperature r = 0.51; humidity r = 0.65, both p < 0.01). Maximum daily temperatures above 30°C significantly increased SSI risk (OR = 2.03, p = 0.03). Conclusion This large-scale study is the first to integrate clinical and climatic big data in assessing SSI risk after SFS. In addition to established clinical factors, environmental conditions such as temperature and humidity were shown to influence infection risk. These findings suggest that weather-related factors should be considered in perioperative infection control strategies. Further prospective studies are needed to validate these results and guide clinical practice.