Predictors of Surgical Site Infection Following Craniotomy for Intracranial Neoplasms: An Analysis of Prospectively Collected Data in the ACS-NSQIP Database.

Predictors of Surgical Site Infection Following Craniotomy for Intracranial Neoplasms: An Analysis of Prospectively Collected Data in the ACS-NSQIP Database.

World Neurosurg. 2015 Dec 29;

Authors: McCutcheon BA, Ubl DS, Babu M, Maloney P, Murphy M, Kerezoudis P, Bydon M, Habermann EB, Parney I

Abstract
OVERVIEW: Patients with an intracranial neoplasm are at increased risk for surgical site infection (SSI) following craniotomy relative to patients receiving surgery for other disease processes.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant Use File (PUF) was queried from 2006-2013 for patients who received a resection for an intracranial neoplasm. Multivariable logistic regression analysis was used to identify risk factors associated with SSI.
RESULTS: A total of 12,021 patients met inclusion criteria. SSI occurred at a rate of 2.04%. SSI was significantly associated with increased rates of return to the operating room (56.1% vs. 4.0%, p<0.001) and prolonged postoperative lengths of stay greater than 30 days (5.3% vs. 1.3% p<0.001) on unadjusted bivariate analysis. On multivariable analysis, age (OR 0.991, 95% CI 0.982-0.999) and female gender (OR 0.697, 95% CI 0.538-0.902) were associated with a reduction in the odds of SSI. Preoperative wound infections (OR 3.833, 95% CI 1.834-8.0011), and operative times greater than 4 hours were associated with an increased odds of SSI (OR 1.891, 95% CI 1.298-2.756). Among cases with available chemotherapy data (n=3,504), recent chemotherapy (OR 3.007, 95% CI 1.460-6.196) was associated with an increased odds of SSI.
CONCLUSIONS: This study identified patient risk-factors that may assist clinical decision-making regarding patient risk stratification, timing of surgery, or preoperative antibiotic prophylaxis for patients with an intracranial neoplasm undergoing craniotomy.

PMID: 26743384 [PubMed - as supplied by publisher]

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