A cross-sectional analysis of variables associated with morbidity and mortality in postoperative neurosurgical patients diagnosed with sepsis
Autor: | Ehsan Dowlati, Christopher G. Kalhorn, Juliana Rotter, Kelsey Cobourn |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Foley catheter Patient Readmission Neurosurgical Procedures 030218 nuclear medicine & medical imaging Sepsis 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine medicine Humans Mortality Prospective cohort study Aged business.industry Glasgow Coma Scale Neurointensive care Length of Stay Middle Aged medicine.disease Sputum Female Surgery Neurology (clinical) Neurosurgery Diagnosis code Morbidity medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | Acta Neurochirurgica. 162:2837-2848 |
ISSN: | 0942-0940 0001-6268 |
Popis: | Sepsis is a systemic, inflammatory response to infection associated with significant morbidity and mortality. There is a considerable lack of literature exploring sepsis in neurosurgery. We aimed to identify variables that were correlated with mortality and increased morbidity as defined by readmission and increased length of stay in postoperative neurosurgical patients that met a sepsis diagnosis. A retrospective chart review was conducted of 105 patients who underwent a neurosurgical operation at our institution from 2012 to 2017 who were discharged with at least one sepsis diagnosis code and who did not have a preoperative infection. We identified variables that were correlated with mortality, readmission, and increased length of stay. Patients who survived were preferentially distributed towards lower ASA Physical Status Classification scores. A larger percentage of patients who did not survive had cranial surgery, whereas patients who survived were more likely to have undergone spinal surgery. Higher respiratory rates, higher maximum lactic acid levels, positive sputum cultures, and lower incoming Glasgow Coma Scores (GCS) were significantly correlated with mortality. A larger fraction of readmitted patients had positive surgical site cultures but had negative sputum cultures. Length of hospitalization was correlated with incoming GCS, non-elective operations, and Foley catheter, arterial line, central line, and endotracheal tube duration. Neurosurgical postoperative patients diagnosed with sepsis may be risk stratified for mortality, readmission, and increased length of stay based on certain variables that may help direct their care. Further prospective studies are needed to explore causal relationships. |
Databáze: | OpenAIRE |
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