Korean J Nosocomial Infect Control.
2009 Dec;14(2):88-97.
Risk Factors for Neurosurgical Site Infections after Craniotomy: a Nationwide Prospective Multicenter Study in 2008
- Affiliations
-
- 1Division of Infectious Diseases, Yonsei University Wonju College of Medicine, Wonju, Korea. hyksos@yonsei.ac.kr
- 2Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
- 3Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
- 4Department of Infection Control Office, Wonju Christian Hospital, Wonju, Korea.
- 5Division of Infectious Diseases, Ewha Womans University Mokdong Hospital, Seoul, Korea.
- 6Infection Control Office, Ewha Womans University Mokdong Hospital, Seoul, Korea.
- 7Infection Control Office, Ajou University Hospital, Suwon, Korea.
- 8Infection Control Office, Keimyung University Dongsan Medical Center, Daegu, Korea.
- 9Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam, Korea.
- 10Department of Infectious Diseases, Dongguk University International Hospital, Goyang, Korea.
- 11Division of Infectious Diseases, Gachon University Gil Medical Center, Incheon, Korea.
- 12Division of Infectious Diseases, Gachon University Gil Medical Center, Incheon, Korea.
- 13Infection Control Unit, Gachon University Gil Medical Center, Incheon, Korea.
- 14Division of Infectious Diseases, Yonsei Medical Center, Seoul, Korea.
Abstract
- BACKGROUND
Neurosurgical site infection may have serious sequelae, especially that occurring after craniotomy. A nationwide prospective multicenter study was performed in Korea to determine the incidence and risk factors for surgical site infections (SSI) after craniotomy.
Methods
We collected demographic data, clinical and operative risk factors for SSI, and information regarding the antibiotics administered for the patients who underwent craniotomy in 17 hospitals between July and December of 2008. All the data were collected using a real-time web-based reporting system.
RESULTS
Of the 1,020 patients who underwent craniotomy, 31 (3%) developed SSI, including 4 with superficial incisional SSI, 2 with deep incisional SSI, and 25 with organ/space SSI. The SSI rate was predicted on the basis of the National Nosocomial Infections Surveillance (NNIS) risk index. The SSI rate of 3.1%, 3.3%, and 1.8% were ascribed NNIS scores of 0, 1, and 2, respectively. The independent risk factors for SSI identified were postoperative cerebrospinal fluid leakage (odds ratio, 12.13; 95% confidence interval, 4.54-32.42) and preoperative Glasgow coma scales score < or =8 (odds ratio, 2.35; 95% confidence interval, 1.07-5.18). Third generation cephalosporins were the most frequently (in 65.6% of the cases) used for prophylaxis.
CONCLUSION
A multicenter SSI surveillance system for craniotomy was first established in Korea. The NNIS risk index was not effective in identifying the patients at risk. We required to further analyze a large number of SSI cases to correctly identify the risk factors for SSI after craniotomy.
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