Study design:

Retrospective Cohort OBJECTIVE: Determine if a penicillin allergy is an independent risk factor for poor outcomes following anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF).

Methods:

A retrospective database review was performed using the PearlDiver dataset. The study population included all patients less than 85 years of age who underwent elective PLF or ACDF with diagnosis of penicillin allergy using International Classification of Disease (ICD) codes. Study patients were compared to controls for 90-day complications and 1-year reoperation rates. A multivariate logistic regression was used to determine the independent effect of penicillin allergy on the postoperative outcomes.

Results:

PLF cohort multivariate analysis revealed that patients with a penicillin allergy had a significantly increased risk of sepsis (2.6% vs 2.0%, p=0.020), UTI (10.8% vs. 8.4%, p<0.001), emergency-room visits (27.3% vs 20.2%, p<0.001), and readmissions (9.6% vs 6.4%, p<0.001) within 90-days index of surgery. Similarly, the ACDF cohort multivariate analysis showed that a penicillin allergy was associated with an increased risk of sepsis (1.8% vs 1.1 %, p<0.001), emergency room visits (27.2% vs 20.7%, p<0.001), and readmissions (6.8% vs 5.6%, p=0.003) within 90-days index of surgery.

Conclusions:

The present study found that a reported penicillin allergy is associated with an increase in sepsis, UTI, emergency room visit, and readmission postoperatively within 90 days following PLF and ACDF. The findings can help physicians provide patients more comprehensive preoperative counseling in the setting of patient-reported penicillin allergy.