Exploring the Risks of Postoperative Surgical Site Infection After Craniotomy: A Retrospective Cohort Study

Abstract

Objective:  To assess the risk of postoperative surgical site infection after craniotomy and identify risk factors for such infection. Methodology: This retrospective Cohort study was conducted in the Department of Neurosurgery, M C/BKMCMardan, from January to June 2024, including 100 patients who underwent craniotomy. We collected patient data from medical records, including demographic, clinical, and operative data. We identified all patients with SSI within 30 days after surgery based on the Centers for Disease Control and Prevention (CDC) definition. We performed statistical analyses using SPSS version 27.0. We presented continuous variables as mean ± SD and categorical variables as frequencies and percentages, and used logistic regression to identify independent predictors. We considered p < 0.05 statistically significant. Results: Of the 100 patients, 18 (18.0%) developed postoperative SSI. The mean age was 48.7 ± 15.3 years, with 61% males and 39% females. Patients with SSI were significantly older than those without infection (56.2 ± 13.1 vs. 47.1 ± 15.2 years; p=0.018). Diabetes mellitus was more frequent in the SSI group (33.3% vs. 11.0%; p=0.011). Operative duration exceeding four hours (72.2% vs. 35.4%; p=0.004), emergency craniotomy (50.0% vs. 22.0%; p=0.021), and smoking (44.4% vs. 19.5%; p=0.028) were significantly associated with SSI. Conclusion: SSI is a common post-craniotomy complication. Advanced age, diabetes, prolonged surgery, emergency procedures, and smoking increase risk, while prevention strategies reduce infection rates.