Patient nutritional status is associated with surgical site infections in meningioma patients undergoing craniotomy for tumor resection.

Abstract

Introduction: Surgical site infections (SSIs) represent a significant burden to patients and healthcare systems. We sought to identify risk factors associated with post-operative SSIs for patients undergoing surgery for the resection of an intracranial meningioma.

Methods: The authors retrospectively reviewed records of meningioma patients who had undergone surgical resection at a single institution between January 2005 and December 2020. Demographics, clinical characteristics, and preoperative nutrition indices were collected through manual chart review. Scalp incisions were categorized as linear/curvilinear, reverse question mark, trapdoor or frontotemporal. The Mann-Whitney U and Fisher exact tests were used for bivariate analyses of continuous variables and categorical variables respectively. Multivariate logistic regression was used to assess factors associated with SSI.

Results: A total of 304 meningioma cases were identified, 15 (4.9%) of which were diagnosed with a postoperative SSI. Patients in the SSI group were significantly more likely to have a non-skull base meningioma (80% vs. 46.4%, p = 0.01), gross total resection (GTR) of tumor (93.3% vs. 67.8%, p = 0.04), and previous diagnosis of diabetes mellitus (DM) (40% vs. 15.2%, p = 0.02). Patients in the SSI group also had a significantly higher average Charlson comorbidity index (CCI) (2.8 ± 2.3 vs. 1.7 ± 2.2, p = 0.03) and a significantly lower nutritional risk index (NRI) (97.8 ± 4.9 vs. 103.9 ± 7.8, p < 0.01). On multivariate analysis, decreasing NRI score (OR 0.91, 95% CI 0.84-0.98, p = 0.02) is independently associated with development of an SSI.

Conclusions: Results from this study indicate that preoperative nutritional status is a significant risk factor for SSI development in meningioma patients. These findings may be used to drive risk stratification efforts for this vulnerable patient population.