Day-30 Nosocomial Infection in HIV Positive and HIV Negative Patients with A Spontaneous Intracerebral Hematoma Taken for Operative Intervention In South Africa - A Prospective Cohort Study

Introduction: Patients diagnosed with a spontaneous intracerebral hematoma taken for operative intervention often develop a nosocomial infection at some point during their in-patient stay. Materials and methods: A prospective cohort study performed by consecutively enrolling 38/70 (54%) HIV negative subjects and 32/70 (46%) HIV positive subjects admitted to our neurosurgical unit over a 24-month period, with an intracerebral hematoma who were taken for operative intervention, were followed up to evaluate our day-30 nosocomial infection incidence. SMUREC/M/32/2022: PG. Results: In our study significance was demonstrated between pre-admission diabetes mellitus (p=0.004) and pre-admission anticoagulant use (p=0.02), both of which demonstrated significant positive predictive value in that our subjects admitted with a spontaneous intracerebral hematoma, with either of these two specific co-morbidities, incurred a significantly increased risk of acquiring a day-30 nosocomial infection. Several clinical trends were demonstrated, that did not reach significance, but trended towards in increased likelihood of acquiring a day-30 nosocomial infection were, increased subject age (p=0.56), a low Glasgow Coma Score (p=0.20), HIV status (p=0.27), primary hypertension (p=0.31), hypercholesterolemia (p=0.18), a putaminal basal ganglia bleed (p=0.54), a larger intracerebral hematoma volume (p=0.41), undergoing a craniotomy (p=0,25), and increased intra-operative blood loss (p=0.26). Regarding outcome subject who incurred a nosocomial infection also trended towards having an unfavorable outcome (p=0.16). Conclusion: We report diabetes mellitus and anti-coagulant use to predict the day-30 nosocomial infection incidence, as well as several clinical trends that are largely supported by the literature.