Risk Factors Analysis For Postoperative Intracranial Infection In Meningiomas

ObjectiveMeningioma is one of the most common type of intracranial tumors.the surgical treatment of removing the tumor is the preferred treatment for patients with meningioma.Intracranial infection is one of the common complications during meningioma operation or after,which affect the rehabilitation of patients,and increase the length of hospital stay,treatment costs,seriously leading to patient’s death.This study was to explpore intracranial infection situation in patients with meningiomas after operation,and analyze the related risk factors for intracranial infection,and provide the control strategy to control the risk factors of intracranial infection.MethodA retrospective survey and analysis method was used.The clinical data of 547 patients with meningiomas who had underwent surgery in the Department of Neurosurgery from Jan.2010 to Dec.2014.The cases of intracranial infection were divided as the infection group,while the other cases without intracranial infection were as the control group.The data collected factors including age,sex,BMI(kg / ㎡);tumor characteristics such as tumor diameter,tumor characteristics,tumor location;history data such as diabetes history,hypertension history,anemia history;preoperative KPS score;Operative time,amount of blooding,the dura mater and skull repair materials,saddle septum damage,cerebrospinal fluid leakage;postoperative cerebrospinal fluid leakage,postoperative intracranial hematoma,the implementation of Intensive care,drainage tube retention time,prophylactic use of antibiotics.The intracranial infection diagnostic criteria referenced to the diagnostic criteria for nosocomial infection(Trial)published by the original Ministry of Health in 2005.The SPSS20.0 software was used to analyze.The univariate analysis with Pearson chi-square test was used for all the relevant factors.The multivariate Logistic stepwise regression analysis was used to analyze the variables which were statistically significant in univariate analysis,which applied with stepwise regression method,the variable selection criteria of 0.05,rejection criteria of 0.1,α of 0.05,bilateral test.P value less of 0.05 means statistically significant difference.ResultOut of 547 cases of meningioma,26 cases were intracranial infection,and the postoperative intracranial infection rate was 4.75%.Univariate analysis showed that age,tumor characteristics,diabetes mellitus,preoperative KPS score,operation time,postoperative cerebrospinal fluid leakage,drainage tube retention time,postoperative intensive care,prophylactic antibiotics were the risk factors for Intracranial Infection.Multivariate logistic regression analysis showed that diabetes mellitus,preoperative KPS score,postoperative cerebrospinal fluid leakage,drainage tube retention time were the risk factors of intracranial infection after meningioma surgery.Prophylactic use of antibiotics was a protective factor for patients with intracranial infection.Conclusion1.The intracranial infection after meningioma surgery is the result of multiple risk factors.Diabetes mellitus,preoperative KPS score,postoperative cerebrospinal fluid leakage,drainage tube retention time are the main risk factors for intracranial infection after meningioma surgery.The strategies such as Preoperative examination,functional status assessment,Preoperative functional status of patients,controlling risk factors for patients with meningioma after surgery are useful to reduce the incidence of intracranial infection.2.The rational use of prophylactic antimicrobial drugs is conducive to preventing intracranial infection of patients with meningioma surgery.