Risk factors for postoperative meningitis after microsurgery for vestibular schwannoma

Abstract

Objective Meningitis after microsurgery for vestibular schwannoma (VS) is a severe complication that results in high morbidity. However, few studies have focused on meningitis after VS surgery. The purpose of this study was to identify the risk factors for meningitis after VS surgery. Methods We performed a retrospective analysis of all VS patients who underwent microsurgery and survived for at least 7 days after surgery, between 1 June 2015 and 30 November 2018 at West China Hospital of Sichuan University. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis (POM). Results We enrolled 410 patients, 27 of whom had POM. Through univariate analysis, the factors of hydrocephalus (p = 0.018), Koos grade IV (p = 0.04), operative duration > 3 hours (p = 0.03) and intraoperative bleeding volume ≥400 ml (p = 0. 02) were significantly correlated with POM. The multivariate analysis showed that Koos grade IV (p = 0.04; OR = 3.19; 95% CI 1.032–3.190), operation duration > 3 hours (p = 0.03; OR = 7.927; 95% CI 1.043–60.265), and intraoperative bleeding volume ≥ 400 ml (p = 0.02; OR = 2.551; 95% CI 1.112–5.850) were the independent influencing factors of POM. Conclusions Koos grade IV, operation duration > 3 hours, and intraoperative blood loss ≥ 400 ml were identified as independent risk factors for POM after microsurgery for VS. POM also caused a prolonged hospital stay.

Risk Factors of Postoperative Meningitis in Lateral Ventricular Trigone Meningiomas: A Clinical Analysis of 64 Patients

“…We found that IBL ≥400 mL was an independent risk factor for the POM. This observation was in-concurrence with previous studies reporting the correlation between IBL and POM ( 33 , 34 ). The large amount of IBL may compromise the patient’s immune system and adversely influence the physiology of local brain tissue.…”

Multi-Layer Onlay Graft Using Hydroxyapatite Cement Placement without Cerebrospinal Fluid Diversion for Endoscopic Skull Base Reconstruction

“…The second feature was that no microorganism was cultured in the CSF specimens. Of course, we could not verify that the negative culture results always corresponded to aseptic meningitis because the isolation rate of the CSF culture was approximately 33% and perioperative antibiotics influenced the culture results [ 15 , 30 ]. The third one was that the time to infection was longer than 8 days (range, 8–38) after the operation in half of the infected patients, which was longer than that of postcraniotomy meningitis.…”

Dynamic Curve Analysis of Indicators Related to Lumbar Cistern Drainage for Postoperative Meningitis

“…Postoperative meningitis after craniotomy is a common complication of neurosurgery and affects the prognosis of surgical patients. Some malignant tumors and tumors of the ventricular system are prone to cause postoperative intracranial infection [14,15]. Bacterial meningitis is more common in infection [16].…”