TY - JOUR
T1 - Early nosocomial infection post-elective brain tumor surgery at a single South African neurosurgical center - a prospective cohort study
AU - Kelly, Adrian
AU - Mda, Siyazi
N1 - Publisher Copyright:
© 2020 The Authors
PY - 2020/9
Y1 - 2020/9
N2 - Introduction: Incurring a nosocomial infection post elective brain tumor surgery can be a devastating complication. Unfortunately, patient demographics, co-morbidities, nature of the neurosurgical procedures performed, and post-operative interventions in the Neurosurgical Intensive Care Unit, are all recognized independent risk factors. Materials and methods: We performed a prospective study by consecutively enrolling 78 elective patients admitted to our hospital with neoplastic brain tumors, from the 01 July 2018 to the 31 March 2020, that were taken for operative resection. Data collected and analyzed in all 78 subjects included age, gender, HIV status, admission Glasgow Coma Score, admission CD4 count, pre-operative steroid treatment, in-hospital stay prior to surgery, pre-operative day CD4 count, operative day Glasgow Coma Score, time between prophylactic antibiotic administration and skin incision, craniotomy type, blood loss, duration of surgery, post-operative steroid therapy, day-7 post-operative nosocomial infection incidence, histological diagnosis, and total length of in-hospital patient stay. Results: Our study results suggest that subjects over the age of 40-years, having an admission and/or pre-operative day absolute CD4 count < 500 cells/mm, having a suboccipital craniotomy/craniectomy performed, and surgery of over 5 h duration, to all suggest trends towards an increased risk of acquiring a day-7 nosocomial infection. Our study results further suggest that being GCS 15/15 on the day of surgery, suggested a trend towards being protective against acquiring a day-7 nosocomial infection. We further report the trend that acquiring a day-7 nosocomial infection leads to a longer total length of in-patient stay. Conclusion: While the clinical trends in our study are largely supported by the literature, according to our PubMed review of the literature we are the first to report the trend that being GCS 15/15 on the day of an elective brain tumor resection procedure is protective against acquiring a day-7 nosocomial infection.
AB - Introduction: Incurring a nosocomial infection post elective brain tumor surgery can be a devastating complication. Unfortunately, patient demographics, co-morbidities, nature of the neurosurgical procedures performed, and post-operative interventions in the Neurosurgical Intensive Care Unit, are all recognized independent risk factors. Materials and methods: We performed a prospective study by consecutively enrolling 78 elective patients admitted to our hospital with neoplastic brain tumors, from the 01 July 2018 to the 31 March 2020, that were taken for operative resection. Data collected and analyzed in all 78 subjects included age, gender, HIV status, admission Glasgow Coma Score, admission CD4 count, pre-operative steroid treatment, in-hospital stay prior to surgery, pre-operative day CD4 count, operative day Glasgow Coma Score, time between prophylactic antibiotic administration and skin incision, craniotomy type, blood loss, duration of surgery, post-operative steroid therapy, day-7 post-operative nosocomial infection incidence, histological diagnosis, and total length of in-hospital patient stay. Results: Our study results suggest that subjects over the age of 40-years, having an admission and/or pre-operative day absolute CD4 count < 500 cells/mm, having a suboccipital craniotomy/craniectomy performed, and surgery of over 5 h duration, to all suggest trends towards an increased risk of acquiring a day-7 nosocomial infection. Our study results further suggest that being GCS 15/15 on the day of surgery, suggested a trend towards being protective against acquiring a day-7 nosocomial infection. We further report the trend that acquiring a day-7 nosocomial infection leads to a longer total length of in-patient stay. Conclusion: While the clinical trends in our study are largely supported by the literature, according to our PubMed review of the literature we are the first to report the trend that being GCS 15/15 on the day of an elective brain tumor resection procedure is protective against acquiring a day-7 nosocomial infection.
KW - Brain tumors
KW - HIV
KW - Nosocomial infection
UR - http://www.scopus.com/inward/record.url?scp=85085512399&partnerID=8YFLogxK
U2 - 10.1016/j.inat.2020.100785
DO - 10.1016/j.inat.2020.100785
M3 - Article
AN - SCOPUS:85085512399
SN - 2214-7519
VL - 21
JO - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
JF - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
M1 - 100785
ER -