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Infections in patients with head injury: a 6-year retrospective study

Abstract number: P831

Kourbeti I., Papadakis J., Karabetsos D., Neophytou C., Filippou M., Ioannou A., Anastasaki M., Vakis A.

Objectives: Infections in patients with traumatic brain injury (TBI) are associated with prolonged hospitalisation and adverse outcomes. The acknowledgement of the pre-disposing risk factors may help decrease the morbidity and mortality

We conducted a retrospective cohort study to determine the incidence, bacteriology and risk factors for development of infection after head injury

Methods: The records of patients >18 years old, admitted with head injury in Crete Univ Med Ctr between 1999 and 2005 were abstracted. Data were analysed with SPSS

Results: 877 events were analysed with a total of 338 surgeries. Burr hole was the most common procedure (28%). Males predominated (75.6%) and the median age was 40. Surgical site infections (SSI) developed in 11.2% of the patients that underwent surgery. Wound infection was the most common (53%). Meningitis/ventriculitis comprised 43% of the SSI. Coagulase negative staphylococci (CNS) predominated as pathogens

Ventilator Associated Pneumonia (VAP) in 7.4% of the entries and they were the most common infections other than SSI. Gram(-) bacilli predominated in VAP with Acinetobacter spp. being the most common

Risk factors for SSI surgery through sinus (p<0.001), CSF leak(p = 0.01), ICU stay (p<0.001), use of a dural substitute (p = 0.01), drain placement and duration of drains, ICP placement (p = 0.01) and concomitant infections (p<0.001). Development of meningitis was associated with surgery through sinus (p<0.001), ICU stay (p<0.0001), CSF leak (p<0.05), use of ventricular drains (p<0.01) and concomitant infections (p<0.001). SSI and meningitis were associated with prolonged hospitalisation but only meningitis with an increased mortality (p<0.05). In multivariate analysis surgery through sinus, ICU stay were associated with development of SSI and meningitis but only SSI with CSF leak

Conclusions: Infections are common in patients with head injury. Superficial and deep SSI are associated with prolonged hospitalisation and increased mortality. Some of the risk factors may be minimised by careful surgical technique and aseptic management of foreign devices. The type and sensitivities of the pathogens must be determined institution by institution for effective empirical treatment

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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