Due to prolonged hospitalization and the complexity of care required for patients with aneurysmal subarachnoid hemorrhage (aSAH), they have a high risk of complications. Risk for wound infection after microsurgical treatment for aSAH was analyzed.
All patients who underwent microsurgical treatment for aSAH (August 1, 2007-July 31, 2019) were retrospectively reviewed from the Post-Barrow Ruptured Aneurysm Trial database. Patients were analyzed for risk factors for wound infection after treatment.
Of 594 patients who underwent microsurgical treatment for aSAH, 23 (3.9%) had wound infections. There was no significant difference between the mean (SD) age of patients with wound infection (52.6 [12.2] years) and patients without infection (54.2 [14.0] years) (P=0.45). The presence of multiple comorbidities (including diabetes, tobacco use, and obesity), external ventricular drain, ventriculoperitoneal shunt, pneumonia, or urinary tract infection was not associated with an increased risk for wound infection. Furthermore, there was no significant difference in mean operative times between patients with wound infection (280 [112] minutes) and patients without infection (260 [92] minutes) (P=0.38). Patients who required a decompressive craniectomy (DC) were at increased risk of wound infection (odds ratio: 5.0, 95% CI: 1.8 to 14.1, P=0.002). Of 23 total infections, 9 were diagnosed following cranioplasty after DC.
Microsurgical treatment for aSAH is associated with a relatively low risk of wound infection. However, patients undergoing a decompressive craniectomy may be at an increased risk for infection. Additional attention and comprehensive wound care are warranted for these patients.
Copyright © 2021. Published by Elsevier Inc.
Decompressive craniectomy and risk of wound infection after microsurgical treatment of ruptured aneurysms.
