Relationship between characteristics of glioma treatment and surgical site infections

• Published in: Acta neurochirurgica Vol. 165; no. 3; pp. 659 - 666
• Main Authors: Kuwano, Atsushi, Saito, Taiichi, Nitta, Masayuki, Tsuzuki, Shunsuke, Koriyama, Shunichi, Tamura, Manabu, Ikuta, Soko, Masamune, Ken, Muragaki, Yoshihiro, Kawamata, Takakazu
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.03.2023; Springer Nature B.V
• Subjects: Brain tumors; Chemotherapy; Glioma; Glioma - complications; Humans; Interventional Radiology; Magnetic resonance imaging; Medicine; Medicine & Public Health; Minimally Invasive Surgery; Multivariate analysis; Neurology; Neuroradiology; Neurosurgery; Neurosurgical Procedures - adverse effects; Original Article - Brain Tumors; Patients; Radiation therapy; Retrospective Studies; Risk Factors; Surgery; Surgical Orthopedics; Surgical site infections; Surgical Wound Infection - etiology; Chemotherapy; Radiation therapy; Neurosurgery; Glioma; Surgical site infections
• ISSN: 0942-0940; 0001-6268; 0942-0940
• DOI: 10.1007/s00701-022-05474-6

Purpose Surgical site infections (SSIs) after neurosurgery are common in daily practice. Although numerous reports have described SSIs in neurosurgery, reports specific to gliomas are limited. This study aimed to investigate the relationship between SSIs and glioma treatment characteristics, such as reoperations, radiation therapy, and chemotherapy. Methods We examined 1012 consecutive patients who underwent craniotomy for glioma between November 2013 and March 2022. SSIs were defined as infections requiring reoperation during the observation period, regardless of their location. We retrospectively analyzed SSIs and patient factors. Results During the observation period, SSIs occurred in 3.1% (31/1012). In the univariate analysis, three or more surgeries ( P  = 0.007) and radiation therapy ( P  = 0.03) were associated with SSIs, whereas intraoperative magnetic resonance imaging (MRI) was not significantly associated ( P  = 0.35). Three or more surgeries and radiation therapy were significantly correlated with each other ( P  < .0001); therefore, they were analyzed separately in the multivariate analysis. Three or more surgeries were an independent factor triggering SSIs ( P  = 0.02); in contrast, radiation therapy was not an independent factor for SSIs ( P  = 0.07). Several SSIs localized in the skin occurred more than 1 year after surgery. Conclusions Undergoing three or more surgeries for glioma is an independent risk factor for SSIs. Glioma SSIs can occur long after surgery. These results are considered characteristic of gliomas. We recommend careful long-term observation of patients at a high risk of SSIs.