title: Postoperative Neurosurgical Infection Rates After Shared-Resource Intraoperative Magnetic Resonance Imaging: A Single-Center Experience with 195 Cases.
abstract: OBJECTIVE
  To determine the rate of surgical-site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database.
  
  
  METHODS
  All consecutive neurosurgical procedures that were performed with a high-field, 2-room ioMRI between April 2013 and June 2016 were included (N = 195; 109 craniotomies and 86 endoscopic transsphenoidal procedures). The incidence of SSIs within 3 months after surgery was assessed for both operative groups (craniotomies vs. transsphenoidal approach).
  
  
  RESULTS
  Of the 109 craniotomies, 6 patients developed an SSI (5.5%, 95% confidence interval [CI] 1.2-9.8%), including 1 superficial SSI, 2 cases of bone flap osteitis, 1 intracranial abscess, and 2 cases of meningitis/ventriculitis. Wound revision surgery due to infection was necessary in 4 patients (4%). Of the 86 transsphenoidal skull base surgeries, 6 patients (7.0%, 95% CI 1.5-12.4%) developed an infection, including 2 non-central nervous system intranasal SSIs (3%) and 4 cases of meningitis (5%). Logistic regression analysis revealed that the likelihood of infection significantly decreased with the number of operations in the new operational setting (odds ratio 0.982, 95% CI 0.969-0.995, P = 0.008).
  
  
  CONCLUSIONS
  The use of a shared-resource ioMRI in neurosurgery did not demonstrate increased rates of infection compared with the current available literature. The likelihood of infection decreased with the accumulating number of operations, underlining the importance of surgical staff training after the introduction of a shared-resource ioMRI.
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Nikolaj
authors.initials: N
authors.lastname: Dinevski
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Sarnthein
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Flavio
authors.initials: F
authors.lastname: Vasella
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Jorn
authors.initials: J
authors.lastname: Fierstra
authors.affiliation: Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Athina
authors.initials: A
authors.lastname: Pangalu
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Holzmann
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Luca
authors.initials: L
authors.lastname: Regli
authors.affiliation: Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Electronic address: oliver.bozinov@usz.ch.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bozinov
mesh_terms: D000038:Abscess / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058565:Cerebral Ventriculitis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007430:Intraoperative Care; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D008581:Meningitis / Q000453:epidemiology; D008875:Middle Aged; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures; D016017:Odds Ratio; D010000:Osteitis / Q000453:epidemiology; D011446:Prospective Studies; D012220:Rhinitis / Q000453:epidemiology; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult
keywords: Complications; Craniotomy; Infection; Shared resource; Transsphenoidal skull base surgery; ioMRI