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Hospital-acquired meningitis in patients undergoing craniotomy: incidence, evolution, and risk factors.

Abstract：

OBJECTIVES:To establish the incidence of postcraniotomy meningitis, identify etiologic agents, assess patients' medical progress in relation to both length of hospitalization and mortality, and analyze risk factors. MATERIAL AND METHODS:This study was developed at Hospital São Paulo, a tertiary university hospital, between August 1995 and January 1998. We conducted a case-control trial, in which 50 pairs of patients were matched. RESULTS:An 8.9%-postcraniotomy meningitis incidence was found. Gram-negative bacilli were the most common etiologic agents isolated. Mortality among the patients was 30%. Mean hospital stay for the patients was 42.9 +/- 22.1 days; for the controls, mean hospital stay was 19.0 +/- 11.4 days (P =.00001). Although several risk factors were identified by univariate analysis, including postoperative external ventricular shunt (OR = 2.92, CI 95% = 1.245-6.865, P =.014), remote site infection (OR = 2.85, CI 95% = 0.995-8.173, P =.051), and repeat operation (OR = 5.02, CI 95% = 1.569-16.066, P =.007), only repeat operation remained in the multivariate analysis model (OR = 3.68, CI 95% = 1.158-11.700, P =.027). CONCLUSION:Postcraniotomy meningitis resulted in a high mortality rate and a longer hospital stay, with repeat operation identified among the risk factors.

journal_name

Am J Infect Control

journal_title

American journal of infection control

authors

Reichert MC,Medeiros EA,Ferraz FA

doi

10.1067/mic.2002.119925

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

158-64

issue

3

eissn

0196-6553

issn

1527-3296

pii

S019665530200648X

journal_volume

30

pub_type

临床试验,杂志文章

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