Case Control Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2023; 11(28): 6680-6687
Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6680
Factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients: A single-center retrospective study
Jiang-Long Wang, Xi-Wen Wu, Sheng-Nan Wang, Xuan Liu, Bing Xiao, Yu Wang, Jing Yu
Jiang-Long Wang, Xi-Wen Wu, Xuan Liu, Bing Xiao, Yu Wang, Jing Yu, The First Operating Room, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Sheng-Nan Wang, Department of Neurology, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Author contributions: Every author has made substantial contributions to the manuscript; Wang JL drafted the article and contributed to editing and revision; Wang SN downloaded datasets and conducted a bioinformatic analysis; Wu XW and Wang SN provided correction and analysis of statistical methods; Liu X, Wang Y and Xiao B contributed to figures and tables; Yu J substantively edited the manuscript; All authors read and approved the final version of this manuscript.
Institutional review board statement: The study was reviewed and approved by the first hospital of Jilin university Institutional Review Board [Approval No. 2023-KS-064].
Informed consent statement: Informed written consent was obtained from the patients for publication of this study.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at yujing@jlu.edu.cn. Participants gave informed consent for data sharing.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Yu, RN, Chief Nurse, The First Operating Room, The First Hospital of Jilin University, Xinmin Road, Changchun 130000, Jilin Province, China. yujing@jlu.edu.cn
Received: June 21, 2023
Peer-review started: June 21, 2023
First decision: August 16, 2023
Revised: September 2, 2023
Accepted: September 6, 2023
Article in press: September 6, 2023
Published online: October 6, 2023
Abstract
BACKGROUND

At present, many studies have reported the risk factors for postoperative intracranial reinfection, including age, sex, time to surgery, duration of postoperative catheterization, emergency procedures, type of disease and cerebrospinal fluid leakage, but the academic community has not reached a unified conclusion.

AIM

To find factors influencing the surveillance of re-emerging intracranial infections in elective neurosurgical patients.

METHODS

Ninety-four patients who underwent elective craniotomy from January 1, 2015 to December 31, 2022 in the Department of Neurosurgery, First Hospital of Jilin University, were included in this study. Of those, 45 patients were enrolled in the infection group, and 49 were enrolled in the control group. The clinical data of the patients were collected and divided into three categories, including preoperative baseline conditions, intraoperative characteristics and postoperative infection prevention. The data were analyzed using SPSS 26.0 software.

RESULTS

There were 23 males and 22 females in the infection group with a mean age of 52.8 ± 15.1 years and 17 males and 32 females in the control group with a mean age of 48.9 ± 15.2 years. The univariate analysis showed that the infection group had higher systolic blood pressures and postoperative temperatures, fewer patients who underwent a supratentorial craniotomy, more patients with a history of hypertension and higher initial postoperative white blood cell counts than the control group, with statistically significant differences (P < 0.05). The multifactorial logistic regression analysis showed that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative infection in neurosurgical patients.

CONCLUSION

The results obtained in this study indicated that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative neurological symptoms.

Keywords: Re-emerging infections, Risk factors, Neurosurgery, Elective surgery, Intracranial infections

Core Tip: A postoperative intracranial reinfection not only increases the mortality rate, economic burden and length of hospitalization but may even cause permanent sequelae to the patient. The results obtained in our study indicated that a history of hypertension and a high postoperative body temperature were independent risk factors for postoperative neurologic complications that mostly occur within the first 3 d after surgery. The identified risk factors provide a basis for recommending future prevention strategies.