An audit of surgical site infections among Omani travelers to India for spinal surgery

INTRODUCTION: Many Omani nationals travel to India for Spine surgery. Surgical site infection (SSI) rates in these patients is considered more than normal. The indications for surgery are also deemed liberal. Objective: To determine whether SSI rates are more in medical tourists. MATERIALS & METHODS: Design: The submission is a retrospective observational study done at a tertiary care referral hospital in Oman. The participants were a cohort of 125 patients who had travelled to India for spine surgery between January 2013 and December 2015. Their data was retrieved from the hospital information system. They were evaluated for satisfaction, residual complaints, surgical site infection and putative indications for surgery. The primary outcome measure was surgical site infection. The SSI rates were compared to a group of patients treated in-house during the same period. RESULTS: All the surgeries done were in the private sector. Fifty-four of the 80 cases were advised surgery locally as well, while 26 were advised against intervention. There were 15 cases of SSI, 10 of them needing re-operation. Four patients had neurological deterioration with 2 wrong level surgeries. DISCUSSION & CONCLUSIONS: The rate of SSI in medical tourism patients was 12% compared to the 2.7% native cases. There was a 78% chance of improvement when the surgery was locally approved and 74% chance of worsening when not approved.