PMID- 27671880
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20220330
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 97
DP  - 2017 Jan
TI  - Neurosurgical Infection Rates and Risk Factors: A National Surgical Quality 
      Improvement Program Analysis of 132,000 Patients, 2006-2014.
PG  - 205-212
LID - S1878-8750(16)30886-5 [pii]
LID - 10.1016/j.wneu.2016.09.056 [doi]
AB  - BACKGROUND: The existing body of literature on postoperative neurosurgical 
      infections lacks large multicenter reports on postoperative neurosurgical 
      infections. This is the largest study to date of postoperative neurosurgical 
      infections rates, time to event, and risk factors. METHODS: Demographics, medical 
      history, and postoperative infections were assessed for all adult patients in the 
      large, randomized, multicenter American College of Surgeons-National Surgical 
      Quality Improvement Program (ACS-NSQIP) database undergoing an operation with a 
      surgeon whose primary specialty was neurological surgery from 2006 to 2014. 
      RESULTS: Of 3,723,797 cases from 517 institutions in the NSQIP from 2006 to 2014, 
      132,063 neurosurgery cases were identified. Within these patients, the 30-day 
      rate of postoperative infections was 5.3%. Postoperatively, 1.8% of patients 
      developed surgical site infections (SSI), and 3.9% developed other infections 
      including pneumonia and urinary tract infections. Superficial SSI had a 
      cumulative incidence of 0.8% at a median of 16 (interquartile range [IQR], 11-22) 
      days. Pneumonia had a cumulative incidence of 1.4% at a median of 5 days (IQR, 
      2-10 days). Systemic inflammatory response syndrome had a cumulative incidence of 
      1.6% at a median of 3 days (IQR, 8-16 days). Predictors of postoperative 
      infections on multivariable analysis included female sex, older age, obesity, 
      functionally dependent status before surgery, ventilator dependence, preoperative 
      steroid use, bleeding disorders, hyponatremia, lymphocytosis, anemia, 
      thrombocytosis, emergent case status, wound class II-IV, American Society of 
      Anesthesiologists class 3-5, and longer operative times. CONCLUSION: The overall 
      ACS-NSQIP reported rate of postoperative infections was 5.3% from 2006 to 2014. 
      Multivariable analysis demonstrated several predictive factors for postoperative 
      infections.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Karhade, Aditya V
AU  - Karhade AV
AD  - Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Cote, David J
AU  - Cote DJ
AD  - Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Larsen, Alexandra M G
AU  - Larsen AM
AD  - Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
FAU - Smith, Timothy R
AU  - Smith TR
AD  - Cushing Neurosurgery Outcomes Center, Department of Neurosurgery, Brigham and 
      Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic 
      address: trsmith@partners.org.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160923
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Aged
MH  - Databases, Factual/*trends
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neurosurgical Procedures/*adverse effects/standards/*trends
MH  - Prospective Studies
MH  - Quality Improvement/standards/*trends
MH  - Risk Factors
MH  - Surgical Wound Infection/diagnosis/*epidemiology
OTO - NOTNLM
OT  - Complications
OT  - Infection
OT  - NSQIP
OT  - Neurosurgery
OT  - Organ space infections
OT  - Quality improvement
OT  - Surgical site infections
OT  - Urinary tract infections
EDAT- 2016/09/28 06:00
MHDA- 2017/09/19 06:00
CRDT- 2016/09/28 06:00
PHST- 2016/05/26 00:00 [received]
PHST- 2016/09/11 00:00 [revised]
PHST- 2016/09/13 00:00 [accepted]
PHST- 2016/09/28 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2016/09/28 06:00 [entrez]
AID - S1878-8750(16)30886-5 [pii]
AID - 10.1016/j.wneu.2016.09.056 [doi]
PST - ppublish
SO  - World Neurosurg. 2017 Jan;97:205-212. doi: 10.1016/j.wneu.2016.09.056. Epub 2016 
      Sep 23.