Risk factors and morbidity associated with surgical site infection subtypes following adult neurosurgical procedures.
| Autor: | Adapa AR; Medical School, University of Michigan, Ann Arbor, MI, USA.; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA., Linzey JR; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA., Moriguchi F; Medical School, University of Michigan, Ann Arbor, MI, USA., Daou BJ; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA., Khalsa SSS; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA., Ponnaluri-Wears S; Infection Prevention and Epidemiology, Michigan Medicine, Ann Arbor, MI, USA., Thompson BG; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA., Park P; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA.; Department of Orthopedic Surgery, Michigan Medicine, Ann Arbor, MI, USA., Pandey AS; Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, USA. |
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| Jazyk: | angličtina |
| Zdroj: | British journal of neurosurgery [Br J Neurosurg] 2024 Apr; Vol. 38 (2), pp. 503-509. Date of Electronic Publication: 2021 Mar 29. |
| DOI: | 10.1080/02688697.2021.1905773 |
| Abstrakt: | Objective: Studies on surgical site infection (SSI) in adult neurosurgery have presented all subtypes of SSIs as the general 'SSI'. Given that SSIs constitute a broad range of infections, we hypothesized that clinical outcomes and management vary based on SSI subtype. Methods: A retrospective analysis of all neurosurgical SSI from 2012-2019 was conducted at a tertiary care institution. SSI subtypes were categorized as deep and superficial incisional SSI, brain, dural or spinal abscesses, meningitis or ventriculitis, and osteomyelitis. Results: 9620 craniotomy, shunt, and fusion procedures were studied. 147 procedures (1.5%) resulted in postoperative SSI. 87 (59.2%) of these were associated with craniotomy, 36 (24.5%) with spinal fusion, and 24 (16.3%) with ventricular shunting. Compared with superficial incisional primary SSI, rates of reoperation to treat SSI were highest for deep incisional primary SSI (91.2% vs 38.9% for superficial, p < 0.001) and second-highest for intracranial SSI (90.9% vs 38.9%, p = 0.0001). Postoperative meningitis was associated with the highest mortality rate (14.9%). Compared with superficial incisional SSI, the rate of readmission for intracranial SSI was highest (57.6% vs 16.7%, p = 0.022). Conclusion: Deep incisional and organ space SSI demonstrate a greater association with morbidity relative to superficial incisional SSI. Future studies should assess subtypes of SSI given these differences. |
| Databáze: | MEDLINE |
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