Risk Factors Of Intracranial Bacterial Infection After Craniocerebral Tumor Surgery

Objective: Through retrospective analysis,the independent risk factors of post-craniotomy intracranial infection(PCII)after craniocerebral tumor surgery were explored to provide reference and help for clinicians to prevent and treat postoperative intracranial infection.Methods: The clinical data of patients undergoing craniocerebral tumor surgery in Suining central hospital from January 1,2016 to January 1,2021 were collected.General demographic data: age,sex;medical history data: hydrocephalus,preoperative neutrophil to lymphocyte ratio(NLR),preoperative platelet to lymphocyte ratio(PLR),with corticosteroids,seizures,serum albumin globulin ratio(AGR);surgery-related data: tumor anatomy,tumor pathological features,cerebrospinal fluid leakage,lumbar drainage,number of drainage tubes,Operation time and blood loss.According to the diagnosis of intracranial infection,the cases were divided into intracranial infection group and non-infection group.The data were retrospectively analyzed using SPSS 19.0 statistical software.For enumeration data,the chi-square test was used(Fisher’s exact test was used when the theoretical frequency was less than 5);for measurement data,the receiver operating characteristic curve(ROC)was drawn,and the Youden index was calculated to find the optimal ROC curve threshold.It is divided into binary variables for statistics,and then verified by chi-square test.The research indicators with statistical significance in the univariate analysis were included in the multivariate Logistic regression analysis,and the test level was α=0.05.Results: Among the 447 patients,45 had intracranial infection,and the infection rate was10.06%.Among the 182 males,29 had intracranial infection,the infection rate was 15.93%;265 females,16 had intracranial infection,the infection rate was 6.04%.Univariate analysis results: gender,infratentorial tumor,cerebrospinal fluid leakage,useing of corticosteroids,operation time≥4.5h,preoperative NLR≥2.70,preoperative PLR≥221.5,and blood loss ≥ 250 ml,there were statistically significant differences(P<0.05).Multivariate Logistic regression analysis: infratentorial tumors,preoperative NLR≥2.70 had no significant difference(P>0.05);gender,cerebrospinal fluid leakage,use of corticosteroids,operation time ≥ 4.5h,preoperative NLR ≥ 2.70,blood loss ≥ 250 ml difference was statistically significant(P<0.05).Conclusion:(1)The male patients,postoperative cerebrospinal fluid leakage,with corticosteroids,operation time≥4.5 h,preoperative NLR≥2.70,and blood loss≥250 ml are independent risk factors for intracranial infection after craniocerebral tumor surgery.Leaks have the greatest impact on intracranial infections.(2)Infratentorial tumor and PLR≥221.5 are risk factors for intracranial infection after craniocerebral tumor surgery,but they are not independent risk factors.(3)The differences of gender which affect postoperative intracranial infection needs to be further explored and studied.(4)The preoperative NLR-PLR combined score can detect the high-risk patients with intracranial infection more early than a single inflammatory index.