Background: Although surgical site infection after craniotomy (SSI-CRAN) is a serious complication, risk factors for\nits development have not been well defined. We aim to identify the risk factors for developing SSI-CRAN in a large\nprospective cohort of adult patients undergoing craniotomy.\nMethods: A series of consecutive patients who underwent craniotomy at a university hospital from January 2013 to\nDecember 2015 were prospectively assessed. Demographic, epidemiological, surgical, clinical and microbiological\ndata were collected. Patients were followed up in an active post-discharge surveillance programm e for up to one\nyear after surgery. Multivariate analysis was carried out to identify independent risk factors for SSI-CRAN.\nResults: Among the 595 patients who underwent craniotomy, 91 (15.3%) episodes of SSI-CRAN were recorded, 67\n(73.6%) of which were organ/space. Baseline demographic characteristics were similar among patients who developed\nSSI-CRAN and those who did not. The most frequent causative Gram-positive organisms were Cutibacterium acnes (23.1%)\nand Staphylococcus epidermidis (23.1%), whereas Enterobacter cloacae (12.1%) was the most commonly isolated Gramnegative\nagent. In the univariate analysis the factors associated with SSI-CRAN were ASA score > 2 (48.4% vs. 35.5% in\nSSI-CRAN and no SSI-CRAN respectively, p = 0.025), extrinsic tumour (28.6% vs. 19.2%, p = 0.05), and re-intervention (4.4%\nvs. 1.4%, p = < 0.001). In the multivariate analysis, ASA score > 2 (AOR: 2.26, 95% CI: 1.32â??3.87; p = .003) and re-intervention\n(OR: 8.93, 95% CI: 5.33â??14.96; p < 0.001) were the only factors independently associated with SSI-CRAN.\nConclusion: The risk factors and causative agents of SSI-CRAN identified in this study should be considered in the design\nof preventive strategies aimed to reduce the incidence of this serious complication.
Loading....