Nosocomial infections and their associated risk factors in post-craniotomy patients: a multivariate analysis

Abstract Introduction Craniotomy is a frequent neurosurgical procedure; nosocomial infections following this can lead to additional risks in patients, increasing morbidity and causing fatal consequences. Objectives This work aimed to describe the primary nosocomial infections and identify the risk factors associated with nosocomial infections in patients undergoing craniotomy. Methods A quantitative retrospective study was developed. Data were collected from the digital clinical records system at Hospital III Daniel Alcides Carrión in Tacna. A multivariate analysis used Poisson regression with robust variance to determine independent risk factors. Results A total of 107 patients underwent craniotomy were included in the study, 49 patients (45.79%) developing at least one nosocomial infection. Our analysis identified several significant risk factors for the development of these infections, including admission to the critical care unit as a postoperative destination [RR = 2.34 (1.26–4.33), p = 0.007], hypertension [RR = 1.74 (1.07–2.83), p = 0.024], and the presence of perioperative antibiotic coverage [RR = 1.51 (1.05–2.17), p = 0.025]. The main types of nosocomial infections were pneumonia (63.27%), urinary tract infections (44.90%), bacteremia (16.33%), and ventriculitis (10.20%). The most frequently isolated pathogen was Klebsiella pneumoniae , accounting for 22.12% of the infections, followed by Pseudomonas aeruginosa (20.19%) and Escherichia coli (10.58%). Conclusion Our study demonstrates that admission to a critical care unit, hypertension, and perioperative antibiotic coverage are independent risk factors for nosocomial infections in post-craniotomy patients. These findings highlight the need for targeted prevention strategies to mitigate these risks and improve patient outcomes.