Postoperative Neurosurgical Infection Rates After Shared-Resource Intraoperative Magnetic Resonance Imaging: A Single-Center Experience with 195 Cases.
- Dinevski N Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Sarnthein J Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Vasella F Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Fierstra J Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Pangalu A Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Holzmann D Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
- Regli L Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Bozinov O Department of Neurosurgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland. Electronic address: oliver.bozinov@usz.ch.
- 2017-04-02
Published in:
- World neurosurgery. - 2017
Complications
Craniotomy
Infection
Shared resource
Transsphenoidal skull base surgery
ioMRI
Abscess
Adolescent
Adult
Aged
Aged, 80 and over
Cerebral Ventriculitis
Child
Child, Preschool
Craniotomy
Databases, Factual
Female
Humans
Infant
Intraoperative Care
Logistic Models
Magnetic Resonance Imaging
Male
Meningitis
Middle Aged
Neuroendoscopy
Neurosurgical Procedures
Odds Ratio
Osteitis
Prospective Studies
Rhinitis
Surgical Flaps
Surgical Wound Infection
Young Adult
English
OBJECTIVES
To determine the rate of surgical-site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database.
METHODS
All consecutive neurosurgical procedures that were performed with a high-field, 2-room ioMRI between April 2013 and June 2016 were included (N = 195; 109 craniotomies and 86 endoscopic transsphenoidal procedures). The incidence of SSIs within 3 months after surgery was assessed for both operative groups (craniotomies vs. transsphenoidal approach).
RESULTS
Of the 109 craniotomies, 6 patients developed an SSI (5.5%, 95% confidence interval [CI] 1.2-9.8%), including 1 superficial SSI, 2 cases of bone flap osteitis, 1 intracranial abscess, and 2 cases of meningitis/ventriculitis. Wound revision surgery due to infection was necessary in 4 patients (4%). Of the 86 transsphenoidal skull base surgeries, 6 patients (7.0%, 95% CI 1.5-12.4%) developed an infection, including 2 non-central nervous system intranasal SSIs (3%) and 4 cases of meningitis (5%). Logistic regression analysis revealed that the likelihood of infection significantly decreased with the number of operations in the new operational setting (odds ratio 0.982, 95% CI 0.969-0.995, P = 0.008).
CONCLUSIONS
The use of a shared-resource ioMRI in neurosurgery did not demonstrate increased rates of infection compared with the current available literature. The likelihood of infection decreased with the accumulating number of operations, underlining the importance of surgical staff training after the introduction of a shared-resource ioMRI.
To determine the rate of surgical-site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database.
METHODS
All consecutive neurosurgical procedures that were performed with a high-field, 2-room ioMRI between April 2013 and June 2016 were included (N = 195; 109 craniotomies and 86 endoscopic transsphenoidal procedures). The incidence of SSIs within 3 months after surgery was assessed for both operative groups (craniotomies vs. transsphenoidal approach).
RESULTS
Of the 109 craniotomies, 6 patients developed an SSI (5.5%, 95% confidence interval [CI] 1.2-9.8%), including 1 superficial SSI, 2 cases of bone flap osteitis, 1 intracranial abscess, and 2 cases of meningitis/ventriculitis. Wound revision surgery due to infection was necessary in 4 patients (4%). Of the 86 transsphenoidal skull base surgeries, 6 patients (7.0%, 95% CI 1.5-12.4%) developed an infection, including 2 non-central nervous system intranasal SSIs (3%) and 4 cases of meningitis (5%). Logistic regression analysis revealed that the likelihood of infection significantly decreased with the number of operations in the new operational setting (odds ratio 0.982, 95% CI 0.969-0.995, P = 0.008).
CONCLUSIONS
The use of a shared-resource ioMRI in neurosurgery did not demonstrate increased rates of infection compared with the current available literature. The likelihood of infection decreased with the accumulating number of operations, underlining the importance of surgical staff training after the introduction of a shared-resource ioMRI.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.wneu.2017.03.093
- PMID 28363833
- Persistent URL
- https://sonar.ch/global/documents/298537
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