Predictors of intracranial brain surgery site infection: preoperative chemotherapy and glucocorticoid applications

Ref: Lieber BA,et alJNeurosurg2015 Nov 6: 1-9It remains to be seen whether the preoperative use of chemotherapy drugs or glucocorticoidswill increase the incidence of infection (SSI) at the surgical site after surgeryBryan ALieber of Neurosurgery at New York University and others conducted a study analyzing the effects of chemotherapy drugs or glucocorticoids on SSI within 30 days of surgery, published in November 2015J.JNeurosurgonlinethe study collected data on 8,215 neurosurgery patients in the American College of Surgeons' National Surgical Quality Improvement Program (ACSNSQIP) database between 2006 and 2012Exclude brain trauma, age 18 years and preoperative infectionsFor patients who used chemotherapy drugs or glucocorticoids within 30 days of surgery, the incidence of scalp superficiality, scalp depth and intracranial SSI was counted, respectively, within 30 days of surgeryanalysis showed that 158 (1.92%) of 8215 patients had SSI, and 52 cases, 27 cases and 79 cases of intracranial infection were found in the scalp shallow, scalp deep and intracranial infections, respectivelyMulti-factor analysis tips: Preoperative chemotherapy (risk ratio OF OR:5.20, 95% CI2.33-11.62, p 0.0001) and preoperative application of glucocorticoids (risk ratio OR s 1.86, 95% CI1.03-3.37, p-0.04) are independent predictors of intracranial SSI, but cannot be predicted (including shallow and shallow) Deep) SSI; intracranial SSI may also be related to surgical duration (OR-1.16), Class II incision (OR-3.17), body mass index (OR-3.05), etc.; the authors believe that preoperative chemotherapy and the application of glucocorticoids are independent predictors of intracranial SSI, but have no predictive effect on scalp SSI The findings remind clinicians that before doing preoperative preparations for craniofacial surgery, they need to consider adjusting the timing and dose of preoperative chemotherapy and glucocorticoids to reduce the incidence of SSI (The first hospital affiliated with Fujian Medical University, Ding Chenxuan compiled, Fudan University affiliated Huashan Hospital
Huashan Hospital, Dr Huayu , "Outside the God Information" editor-in-chief, Fudan University affiliated Huashan Hospital Chen Rongcheng Professor Final Review)