Risk factors for neurosurgical site infections: an 18-month prospective survey.
OBJECTIVE
The purpose of this study was to determine the incidence rate and risk factors of surgical site infections (SSIs) in neurosurgery for any type of surgery and any American Society of Anesthesiologists class.


METHODS
The authors undertook an exhaustive 18-month prospective survey including patients who underwent neurosurgery. In particular, a 30-day follow-up was completed in patients whose surgery did not involve placement of a prosthesis or implant, and 1-year follow-up was completed for patients who underwent surgery to place a prosthesis or implant. The Centers for Disease Control definition of SSI was used. Univariate and multivariate analyses were conducted; all dependent variables found in univariate analysis were entered in the multiple regression model. A stepwise multiple logistic regression method was used.


RESULTS
Of the 844 patients studied, 35 SSIs were diagnosed, yielding an incidence rate of 4.1% (95% confidence interval 3.6-4.5). Independent predictive risk factors for infection were cerebrospinal fluid leakage, external shunt, Altemeier class, and further neurosurgery. A lack of antibiotic prophylaxis was not found to be a risk factor.


CONCLUSIONS
Infection risk factors occur mainly during the postoperative period.
Lietard
Claire
C
Laboratoire Universitaire de Santé Publique et Epidémiologie, Faculté de Médecine et Sciences de la Santé de Brest, UBO, and, Service de Santé Publique, Hygiène Hospitalière, Evaluation, CHU Brest, France. claire.lietard@univ-brest.fr
Thébaud
Véronique
V
Besson
Gérard
G
Lejeune
Benoist
B
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002557:Cerebrospinal Fluid Shunts / Q000706:statistics & numerical data; D003399:Craniotomy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008581:Meningitis / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000706:statistics & numerical data*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control
D000900:Anti-Bacterial Agents