Postoperative Neurosurgical Infection Rates After Shared-Resource Intraoperative Magnetic Resonance Imaging: A Single-Center Experience with 195 Cases
Postoperative Neurosurgical Infection Rates After Shared-Resource Intraoperative Magnetic Resonance Imaging: A Single-Center Experience with 195 Cases
复制标题
DOI：
10.1016/j.wneu.2017.03.093
复制
发表时间：
2017-07-01
影响因子：
2
通讯作者：
Bozinov, Oliver
中科院分区：
文献类型：
--
作者：
Dinevski, Nikolaj;Sarnthein, Johannes;Bozinov, Oliver
目的：确定来自前瞻性临床质量管理数据库的单一机构涉及共享资源术中磁共振成像 (ioMRI) 扫描仪的神经外科手术中手术部位感染 (SSI) 的发生率。 方法：纳入 2013 年 4 月至 2016 年 6 月期间使用高场 2 室 ioMRI 进行的所有连续神经外科手术（N = 195；109 例开颅手术和 109 例开颅手术）。 86 内窥镜经蝶手术）。评估两个手术组（开颅手术与经蝶入路）术后 3 个月内 SSI 的发生率。结果：在 109 例开颅手术中，6 例患者发生 SSI（5.5%，95% 置信区间 [CI] 1.2-9.8%），其中浅表 SSI 1 例，骨瓣骨炎 2 例，颅内脓肿 1 例，颅内脓肿 2 例。脑膜炎/脑室炎。 4 名患者 (4%) 因感染需要进行伤口修复手术。在86例经蝶颅底手术中，6例患者（7.0%，95% CI 1.5-12.4%）发生感染，其中2例非中枢神经系统鼻内SSI（3%）和4例脑膜炎（5%）。 Logistic 回归分析显示，随着新手术环境中手术数量的增加，感染的可能性显着降低（比值比 0.982，95% CI 0.969-0.995，P = 0.008）。结论：与现有文献相比，在神经外科中使用共享资源 ioMRI 并未显示感染率增加。感染的可能性随着手术次数的增加而降低，这凸显了引入共享资源 ioMRI 后手术人员培训的重要性。
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 performedwith 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 sharedre-source ioMRI.