title: Early prediction of infection after craniotomy for brain tumours.
abstract: Reliably predicting infection soon after craniotomies would prevent infection and reduce treatment costs and hospitalization expenses. Therefore we analysed potential risk factors and blood count data after craniotomies for brain tumours in order to predict infection as soon as possible after surgery. We analysed 139 patients who underwent craniotomies for brain tumours from January 1997 to December 2001, and divided them into four categories (Types A to D) according to the following: increase in their white blood counts (WBCs) from Day 0 to Day 1, maximum WBC between Day 0 and Day 2, and maximum c-reactive protein (CRP) between Day 0 and Day 4 after surgery. We evaluated potential risk factors and the blood count data for infections via logistic regression analysis. Type D patients had a significantly higher rate of infection (p = 0.0123) than the other Types, while Type B patients had the lowest rate among the four groups (p = 0.0006). When Type A patients suffered CSF leakages, they had a significantly higher possibility of meningitis (p < 0.0001) or scalp infection (p = 0.012). In those Type A or D patients who were male, more than 70 years old, and suffered from metastases from primary lung cancer lesions, the possibility of pneumonia was significantly higher (p = 0.0178). In conclusion, we are able to predict infection within four days after craniotomies for brain tumours according to standard blood count data and certain risk factors. This possibility allows for improved care and better clinical outcomes in patients that undergo craniotomies for brain tumours.
authors.affiliation: Department of Neurosurgery, Komagome Metropolitan Hospital, Bunkyo-ku, Tokyo, Japan. shinoura-k@cick.jp
authors.forename: N
authors.initials: N
authors.lastname: Shinoura
authors.forename: R
authors.initials: R
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Okamoto
authors.forename: O
authors.initials: O
authors.lastname: Nakamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D001932:Brain Neoplasms / Q000601:surgery*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D042241:Early Diagnosis; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D007239:Infections / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000209:etiology; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000097:blood / Q000175:diagnosis / Q000209:etiology
chemical_list: D002097:C-Reactive Protein