Predictive factors for bone flap infection after cranioplasty. (April 2022)

• Record Type: Journal Article
• Authors: Tabata, Shinya; Kamide, Tomoya; Suzuki, Kaima; Kurita, Hiroki
• Is Part Of: Journal of clinical neuroscience. Volume 98(2022)
• Page Start: 219
• Page End: 223
• Publication Date: 2022-04
• Subjects: Allergy -- Body temperature -- Smoking -- Cranioplasty -- Graft infection -- Bone flap infection; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.02.020
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Bone flap infection, a complication of cranioplasty, causes lengthy hospitalizations. Few studies have assessed its risk factors, and the exact risks remain unclear. Patient- and surgery-specific predictors of graft infection were investigated. Smoking, allergy, and body temperature on postoperative day 1 were predictive factors. Patients with a fever of 38 °C or higher on day 1 after cranioplasty need monitoring. Abstract: Bone flap infection is often experienced as a complication of cranioplasty. The aim of this study was to investigate predictors of graft infection, including patient-specific and surgery-specific factors. We retrospectively reviewed cases at our institution who underwent cranioplasty following craniectomy for traumatic brain injury, epidural hematoma, subdural hematoma, intracranial hemorrhage, cerebral infarction, subarachnoid hemorrhage, arteriovenous malformation, and bone flap infection after craniotomy. A total of 192 patients were included in this analysis. The graft infection rate was 8.3% (16/192). Smoking (odds ratio [OR] 3.09, 95% confidence interval [CI] 1.03–12.24; p = 0.04), allergy (OR 6.15, 95% CI 1.50–17.31; p < 0.01), and body temperature on postoperative day 1 (OR 2.57, 95% CI 1.14–5.78; p = 0.02) were found to be independent predictors for graft infection. Based on receiver operating characteristic analysis, a body temperature on postoperative day 1 higher than 38.0 °C was selected as the optimal cut-off value for predicting infection after cranioplasty. The sensitivity and specificity were 68% and 72%, respectively. Smoking, allergy, and body temperature on postoperative day 1 predicted complications leading to graft infection. Patients with a fever of 38 °C or higher on day 1 after cranioplasty should be carefully monitored for graft infection.