Oxford craniotomy infections database: A cost analysis of craniotomy infection

Abstract

We describe the process of establishing a large database for the investigation of craniotomy infection and the preliminary results of this database. The initial results have been used to generate a cost analysis for craniotomy infection. The craniotomy infections database prospectively registers craniotomy cases taking place in the John Radcliffe Hospital. In order to achieve this, each patient's details are registered at the time of operation and followed up to identify cases of infection. Infection was defined strictly according to Centre for Disease Control criteria and validated by at least two members of clinical staff. The first 10 months of data are presented here which identifies a total of 245 craniotomies and 20 verified craniotomy infections. An overall infection rate of 8% is identified, and the cost incurred by the neurosurgery department as a result of craniotomy infections is estimated at £1 85 660 for the 10-month period studied. This amounts to a cost per case of infection of £9283.

Postoperative Neurosurgical Infection Rates After Shared-Resource Intraoperative Magnetic Resonance Imaging: A Single-Center Experience with 195 Cases

“…Furthermore, others have reported rates of infection-related reoperations after craniotomy that vary between <1% and 4%. 26,27,36 Both operative groups in our study have an SSI rate that is within the upper half of the range mentioned above. Also, our infection-related reoperation rate after craniotomy is in the upper range of rates described in previous reports.…”

“…Previous studies without specific inclusion of intraoperative MRI reported SSI rates after craniotomy that vary between 1% and 8% with CNS infection rates after transsphenoidal surgery varying between 1.6% and 10%. 19,[22][23][24][25][26][27][28][29][30][31][32][33][34][35] A study on complications in glioma surgery with use of a one-room ioMRI operating suite recently reported a 1.4% incidence of SSIs. Furthermore, others have reported rates of infection-related reoperations after craniotomy that vary between <1% and 4%.…”

Risk factors and outcomes associated with surgical site infections after craniotomy or craniectomy

“…Three studies assessed postoperative outcomes of SSIs after CRANI, but the investigators did not adjust for patients' preexisting conditions. 16,26,30 At the University of Iowa Hospitals and Clinics (UIHC), the SSI rates after CRANI procedures ranged from 2.6% (low risk) to 5.2% (high risk). We previously found that procedures begun before the skin antiseptic dried and procedures during which Gliadel wafers (Arbor Pharmaceuticals, Inc.) were implanted were associated with an increased risk of SSIs.…”

Does chlorhexidine and povidone-iodine preoperative antisepsis reduce surgical site infection in cranial neurosurgery?

“…[1][2][3] In neurosurgery, these consequences, although relatively infrequent, are often more extreme, commonly requiring admission, reoperation and/or prolonged intravenous antibiotic therapy. [4][5][6] Effective preoperative antisepsis is considered a key element in preventing SSIs. The two most commonly used antiseptic agents are chlorhexidine (CHG) and povidone-iodine (PVI).…”