Journal
WORLD NEUROSURGERY
Volume 97, Issue -, Pages 205-212Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2016.09.056
Keywords
Complications; Infection; Neurosurgery; NSQIP; Quality improvement; Organ space infections; Surgical site infections; Urinary tract infections
Categories
Ask authors/readers for more resources
BACKGROUND: The existing body of literature on postoperative neurosurgical infections lacks large multi-center reports on postoperative neurosurgical infections. This is the largest study to date of postoperative neurosurgical infections rates, time to event, and risk factors. METHODS: Demographics, medical history, and post-operative infections were assessed for all adult patients in the large, randomized, multicenter American College of Surgeonse-National Surgical Quality Improvement Program (ACS-NSQIP) database undergoing an operation with a surgeon whose primary specialty was neurological surgery from 2006 to 2014. RESULTS: Of 3,723,797 cases from 517 institutions in the NSQIP from 2006 to 2014, 132,063 neurosurgery cases were identified. Within these patients, the 30-day rate of postoperative infections was 5.3%. Postoperatively, 1.8% of patients developed surgical site infections (SSI), and 3.9% developed other infections including pneumonia and urinary tract infections. Superficial SSI had a cumulative incidence of 0.8% at a median of 16 (interquartile range [IQR], 11-22) days. Pneumonia had a cumulative incidence of 1.4% at a median of 5 days (IQR, 2-10 days). Systemic inflammatory response syndrome had a cumulative incidence of 1.6% at a median of 3 days (IQR, 8-16 days). Predictors of post-operative infections on multivariable analysis included female sex, older age, obesity, functionally dependent status before surgery, ventilator dependence, preoperative steroid use, bleeding disorders, hyponatremia, lymphocytosis, anemia, thrombocytosis, emergent case status, wound class II-IV, American Society of Anesthesiologists class 3-5, and longer operative times. CONCLUSION: The overall ACS- NSQIP reported rate of postoperative infections was 5.3% from 2006 to 2014. Multivariable analysis demonstrated several predictive factors for postoperative infections.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available