title: [Risk factors of postoperative meningitis in patients with chiasm-sellar tumors].
abstract: Postoperative intracranial infectious complications are one of the most topical problems of neurosurgical intensive care due to theirs significant capability to impair outcomes of the main disease.
  
  
  OBJECTIVE
  To define the risk factors of postoperative meningitis in patients with chiasm-sellar tumors.
  
  
  OBJECTIVE
  1. to define the effect of somatic and intracranial risk factors on occurrence of postoperative meningitis in patients after transsphenoidal and transcranial approaches to the tumor. 2. To define the effect of postoperative meningitis on outcomes of treatment in patients after transsphenoidal and transcranial approaches to the tumor.
  
  
  METHODS
  Somatic and intracranial risk factors of occurrence of postoperative meningitis (pneumonia, urinary tract infection, sepsis, intra-abdominal hypertension, the presence of external ventricular and lumbar drainage, monitoring of intracranial pressure, cerebrospinal fluid, and reoperation) were fixed every day. The study was conducted in the ICU of the Burdenko from October, 2010 to July, 2012. The 34 patients (19 males, 15 females) were included in the study (average age 47.5 years). The patients were divided into two groups; 17 patients each group. The group-1 included patients after transcranial approach to the tumor and the group-2 included patients after transsphenoidal approach.
  
  
  RESULTS
  In the group-1 a meningitis occurred in 3 patients (17.6% +/- 9.2%, DI [-0.4 - 35.6]). In the group-2 a meningitis occurred in 7 patients (41.2% +/- 11.9) DI 95% [17.8 - 64.4]. Accumulation of cerebrospinal fluid under the skin flap authentically increased a risk of a meningitis occurrence in patients after transcranial approach to the tumor (p = 0.031). There was no defined statistical significance of other risk factors. But there was defined a trend of the increasing of meningitis occurrence in patients after transsphenoidal approach in case of lumbar drainage or reoperation. Duration of mechanical ventilation and ICU stay in patients with meningitis was authentically longer than in patients without meningitis in both groups. In the group-2 the duration of mechanical ventilation and ICU stay was significantly shorter than in the group-1.
  
  
  CONCLUSIONS
  Meningitis is not a typical complication of postoperative period in patients with transcranial approach to the tumor. After transsphenoidal approach a meningitis occurrence is likely in case of postoperative liquorrhea, lumbar drainage or reoperation. Subcutaneous accumulation of cerebrospinal fluid is a single defined statistically significant risk factor of meningitis. Postoperative meningitis impairs a condition of patients with chiasm-sellar tumors, increases the duration of mechanical ventilation and impairs treatment outcomes.
authors: K A
authors: KA
authors: Popugaev
authors: I A
authors: IA
authors: Savin
authors: O N
authors: ON
authors: Ershova
authors: N V
authors: NV
authors: Kurdyumova
authors: T F
authors: TF
authors: Tabasaransky
authors: A V
authors: AV
authors: Oshorov
authors: B A
authors: BA
authors: Kadashev
authors: P L
authors: PL
authors: Kalinin
authors: M A
authors: MA
authors: Kutin
mesh_terms: D002555:Cerebrospinal Fluid / Q000378:metabolism; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008581:Meningitis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009031:Moscow / Q000453:epidemiology; D009897:Optic Chiasm / Q000473:pathology; D019574:Optic Nerve Neoplasms / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012307:Risk Factors; D012658:Sella Turcica / Q000473:pathology; D016896:Treatment Outcome