Risk Factors for Postoperative Infections in Severe Traumatic Brain Injury Patients Undergoing Emergency Craniotomy

Zhiyu Zhang,1,* Lin Xu,2,* Sheng Xu1 1Emergency Department, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, People’s Republic of China; 2Department of Pediatrics, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sheng Xu, Emergency Department, The Second People’s Hospital of Hunan Province (Brain Hospital of Hunan Province), No. 427, Section 3, Furong Middle Road, Yuhua District, Changsha, Hunan Province, 410007, People’s Republic of China, Email [email protected] and Aim: Severe traumatic brain injury (TBI) patients undergoing emergency craniotomy are at high risk of postoperative infections. This study aims to identify the risk factors associated with these infections to improve patient outcomes.Methods: A retrospective cohort study was conducted, including 312 severe TBI patients who underwent emergency craniotomy at Brain Hospital of Hunan Province between December 2019 and December 2021. Clinical data were collected, and both univariate and multivariate logistic regression analyses were performed to identify risk factors for postoperative infections.Results: Among the 312 patients, 57 (18.3%) developed postoperative infections. Multivariate analysis identified several significant risk factors, including older age (OR=1.75, 95% CI: 1.23– 2.49), prolonged surgery duration (OR=2.01, 95% CI: 1.38– 2.92), presence of preoperative infection (OR=2.59, 95% CI: 1.64– 4.09), and lower Glasgow Coma Scale (GCS) score on admission (OR=1.82, 95% CI: 1.21– 2.74).Conclusion: Identifying patients at high risk for postoperative infections can help guide preventive measures and improve outcomes in severe TBI patients undergoing emergency craniotomy.Keywords: traumatic brain injury, craniotomy, postoperative infections, risk factors, Glasgow Coma Scale