Perioperative risks of intracranial infection after duraplasty in Chiari malformation type I

Abstract Background and Objectives This study aims to assess the risk factors linked to intracranial infection in individuals with Chiari malformation type I (CM-I) undergoing duraplasty, with the goal of providing insights into the clinical prevention and control of postoperative intracranial infections. Methods A retrospective analysis was conducted on the clinical records of 168 patients diagnosed with CM-I who underwent duraplasty at the Department of Neurological Surgery in the First Affiliated Hospital of Chongqing Medical University, from May 2014 to May 2024. The patients were divided into two groups based on the presence or absence of intracranial infection, and clinical data for both groups were collected. Univariate and multivariate logistic regression analyses were performed to investigate potential risk factors for developing intracranial infection postoperatively. Results Of the 168 patients who underwent surgery, 28 cases (16.67%) were classified as the intracranial infection group, while 140 cases (83.33%) were classified as the non-infection group. Multifactorial logistic regression analysis indicated that preoperative anemia, preoperative hypoalbuminemia, operative time exceeding 3 h, surgical incision length exceeding 5 cm, and cauterization of cerebellar tonsils were independent risk factors that influenced the development of postoperative intracranial infection. Conclusion The likelihood of developing intracranial infection following duraplasty in patients with CM-I is influenced by various factors. Specifically, anemia (OR 17.09), hypoalbuminemia (OR 17.71), long operative time (OR 10.93), extended surgical incision (OR 173.25), and cauterization of cerebellar tonsils (OR 31.29) were identified as key contributors to postoperative intracranial infections. These findings emphasize the necessity of optimizing patient health status and refining surgical techniques to mitigate infection risks. Implementing targeted clinical prevention strategies that address these factors may reduce the incidence of postoperative intracranial infections and improve overall patient prognosis.