Influencing Factors Of Intracranial Infection In Patients With Recurrent Glioma After Reoperation

Objective To explore the influencing factors of intracranial infection in patients with recurrent glioma after reoperation.And to provide further epidemiological evidence for prevention and treatment.Methods According to the inclusion and exclusion criteria,a total of 82 cases of recurrent glioma who have received surgical treatment were recruited in June 2010-June 2019 from the southern district of Affiliated provincial hospital of anhui medical university.Factors including personal basic information,history of disease,clinical characteristics of tumor,perioperative regimen,radiation and chemotherapy treatment,factors related to the operation and other factors were collected.A total of 200 patients with primary glioma who underwent surgical treatment at the same time were collected to analyze the differences in the basic characteristics of recurrent glioma and primary glioma.The results of cerebrospinal fluid of postoperatively infected patients were collected to analyze the distribution of pathogenic bacteria.Patients with postoperative infection of recurrent glioma were selected as the case group,and those without postoperative infection as the control group,and the differences in the distribution of the above factors were analyzed.Binary Logistic regression analysis was applied to investigate the independent risk factors for recurrent glioma reoperation.Results The postoperative intracranial infection rate of recurrent glioma(43.9%)wassignificantly higher than that of primary glioma(6.00%).Gram-positive bacteria(56.00%)were the most common cerebrospinal fluid pathogens in patients with recurrent glioma intracranial infection.Furthermore,there were statistically significant differences in the distribution of factors including age ≥ 55 years,diabetes mellitus,concomitant with other malignancies,pathological grade,preoperative chemoradiotherapy,and intraoperative ventricular system opening among patients with primary glioma between primary glioma and recurrent glioma(P<0.05).In the univariate analysis of postoperative intracranial infection in patients with recurrent glioma,age,preoperative diabetes mellitus,intraoperative ventricular system opening,surgical site located under the curtain,and operative time over 4 hours were associated with higher postoperative intracranial infection rate in patients with recurrent glioma.After adjustment for diabetes mellitus,intraoperative ventricular system opening,operative time,and tumor site,age was an independent risk factor for postoperative intracranial infection in patients with recurrent glioma.The OR value of postoperative risk of intracranial infection in patients with recurrent glioma aged more than 55 years was 14.783(95%CI =1.011-216.058).Conclusion The risk of postoperative intracranial infection was significantly higher in patients with recurrent glioma than in patients with primary glioma.Age,preoperative diabetes mellitus,intraoperative ventricular system opening,and long operative time were associated with higher postoperative intracranial infection rate in patients with recurrent glioma.Age ≥ 55 years is an independent risk factor for postoperative intracranial infection in patients with recurrent glioma.