Dataset Information

Risk factors associated with postcraniotomy meningitis: A retrospective study.

ABSTRACT: Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents.We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and December 31, 2012. Postcraniotomy meningitis was diagnosed in 22 out of 4392 surgical patients; this data was reviewed for risk assessment.This study assessed the risk factors for postcraniotomy meningitis and found that it was more frequently seen in patients who were elderly (OR?=?1.57, 95% CI?=?1.32-2.98, P?=?0.013), underwent emergency procedures (OR?=?4.82, 95% CI?=?1.50-14.53, P?=?0.008), had leak of cerebrospinal fluid (OR?=?4.62, 95% CI?=?2.03-10.50, P?=?0.012), had external ventricular drainage (OR?=?4.68, 95% CI?=?2.46-8.87, P?=?0.006), were admitted to the intensive care unit (OR?=?2.41, 95% CI?=?1.53-8.08, P?=?0.012), had used drain placement >72?hours (OR?=?2.66, 95% CI?=?1.04-4.29, P?=?0.007), had surgery >4.5?hours (OR?=?2.38, 95% CI?=?1.39-4.05, P?=?0.005), had repeat operations (OR?=?2.74, 95% CI?=?1.31-5.73, P?=?0.018), endured trauma (OR?=?5.97, 95% CI?=?1.57-17.61, P?=?0.007), or had 30-days mortality (OR?=?5.07, 95% CI?=?2.20-11.48, P?=?0.001). The predominant pathogens isolated from cerebrospinal fluid were Staphylococcus aureus in 8 patients (36.7%) and Acinetobacter baumannii in 7 patients (31.8%). In our study, the mortality rate was 5.1% among all postcraniotomy patients.Accurate risk assessment, early diagnosis, and choice of appropriate antibiotics in accordance with epidemiologic information are the cornerstones of reducing mortality and morbidity in PCM. The changing pattern of infectious agents in PCM over time suggests the necessity of further studies to provide the most up-to-date insight to physicians.

SUBMITTER: Chen CH

PROVIDER: S-EPMC4979789 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Risk factors associated with postcraniotomy meningitis: A retrospective study.

Chen Chang-Hua CH Chang Chih-Yen CY Lin Li-Jhen LJ Chen Wei Liang WL Chang Yu-Jun YJ Wang Shu-Hui SH Cheng Chun-Yuan CY Yen Hua-Cheng HC

Medicine 20160801 31

Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents.We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and De ...[more]

PMID: 27495035

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Project description:BACKGROUND:The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease. METHODS:A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF. RESULTS:A total 667 dengue patients (30.69?±?16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P?<?0.05) associated with DHF than DF. Multivariate regression analysis demonstrated presence of age?>?40 years (OR: 4.1, P?<?0.001), secondary infection (OR: 2.7, P?=?0.042), diabetes mellitus (OR: 2.8, P?=?0.041), lethargy (OR: 3.1, P?=?0.005), thick gallbladder (OR: 1.7, P?=?0.029) and delayed hospitalization (OR: 2.3, P?=?0.037) as independent predictors of DHF. Overall mortality was 1.2 % in our study. CONCLUSIONS:Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile. Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF. Prior knowledge of expected clinical profile and predictors of DHF/DSS development would provide information to identify individuals at higher risk and on the other hand, give sufficient time to clinicians for reducing dengue related morbidity and mortality.

Dataset Information

Risk factors associated with postcraniotomy meningitis: A retrospective study.

Publications

Risk factors associated with postcraniotomy meningitis: A retrospective study.

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