title: Predictors of Surgical Site Infection Following Craniotomy for Intracranial Neoplasms: An Analysis of Prospectively Collected Data in the American College of Surgeons National Surgical Quality Improvement Program Database.
abstract: OBJECTIVE
  To determine the rate of surgical site infection (SSI) after resection of an intracranial neoplasm using the American College of Surgeons National Surgical Quality Improvement Program data set and to identify potential risk factors associated with SSI.
  
  
  METHODS
  The National Surgical Quality Improvement Program Participant Use Data File was queried during the period 2006-2013 for patients who underwent a resection for an intracranial neoplasm. Multivariable logistic regression analysis was used to identify risk factors associated with SSI.
  
  
  RESULTS
  Inclusion criteria were met by 12,021 patients. SSI occurred at a rate of 2.04%. SSI was significantly associated with increased rates of return to the operating room (56.1% vs. 4.0%, P < 0.001) and postoperative lengths of stay >30 days (5.3% vs. 1.3%, P < 0.001) on unadjusted bivariate analysis. On multivariable analysis, age (odds ratio [OR] = 0.991, 95% confidence interval [CI] = 0.982-0.999) and female sex (OR = 0.697, 95% CI = 0.538-0.902) were associated with a reduction in the odds of SSI. Preoperative wound infections (OR = 3.833, 95% CI = 1.834-8.0011) and operative times >4 hours (OR = 1.891, 95% CI = 1.298-2.756) were associated with an increased odds of SSI. Among cases with available chemotherapy data (n = 3504), recent chemotherapy (OR = 3.007, 95% CI = 1.460-6.196) was associated with an increased odds of SSI.
  
  
  CONCLUSIONS
  This study identified patient risk factors that may assist clinical decision making regarding patient risk stratification, timing of surgery, and preoperative antibiotic prophylaxis for patients with an intracranial neoplasm undergoing craniotomy.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: McCutcheon
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Ubl
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Babu
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Maloney
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kerezoudis
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: mohamad.bydon@gmail.com.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Bydon
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Habermann
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Parney
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D015984:Causality; D003399:Craniotomy / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Craniotomy; NSQIP; Predictors; Surgical site infection