Patient nutritional status is associated with surgical site infections in meningioma patients undergoing craniotomy for tumor resection
摘要
Surgical site infections (SSIs) represent a significant burden to patients and healthcare systems. We sought to identify risk factors associated with post-operative SSIs for patients undergoing surgery for the resection of an intracranial meningioma.
MethodsThe authors retrospectively reviewed records of meningioma patients who had undergone surgical resection at a single institution between January 2005 and December 2020. Demographics, clinical characteristics, and preoperative nutrition indices were collected through manual chart review. Scalp incisions were categorized as linear/curvilinear, reverse question mark, trapdoor or frontotemporal. The Mann-Whitney U and Fisher exact tests were used for bivariate analyses of continuous variables and categorical variables respectively. Multivariate logistic regression was used to assess factors associated with SSI.
ResultsA total of 304 meningioma cases were identified, 15 (4.9%) of which were diagnosed with a postoperative SSI. Patients in the SSI group were significantly more likely to have a non-skull base meningioma (80% vs. 46.4%, p = 0.01), gross total resection (GTR) of tumor (93.3% vs. 67.8%, p = 0.04), and previous diagnosis of diabetes mellitus (DM) (40% vs. 15.2%, p = 0.02). Patients in the SSI group also had a significantly higher average Charlson comorbidity index (CCI) (2.8 ± 2.3 vs. 1.7 ± 2.2, p = 0.03) and a significantly lower nutritional risk index (NRI) (97.8 ± 4.9 vs. 103.9 ± 7.8, p < 0.01). On multivariate analysis, decreasing NRI score (OR 0.91, 95% CI 0.84–0.98, p = 0.02) is independently associated with development of an SSI.
ConclusionsResults from this study indicate that preoperative nutritional status is a significant risk factor for SSI development in meningioma patients. These findings may be used to drive risk stratification efforts for this vulnerable patient population.