Analysis Of Risk Factors Of Post Operative Pneumonia After Craniotomy

Objective:To find out risk factors and prevention strategies for postoperative pneumonia by investigating patients undergoing craniotomy restrospectively.Methods:A total of 880 patients who underwent craniotomy between 2014 and 2015 were reviewed in neurosurgery department of a large teaching hospital.Included variables were recorded:gender,age,height,weight,smoking,chest-X ray or CT scan,underlying diseases,surgical wound classification,blood loss,blood transfusion,operation duration,ASA score,surgery stratification,preoperative hospitalized days,tracheotomy,nasogastric tube indwelling,mechanical ventilation and duration,postoperative pneumonia.Independent risk factors associated to postoperative pneumonia were selected by multivariate logistic regression modeling from those significant different variables through univariate analysis by chi-square test and independent sample T test,if the parameters were 1<T<5,the X2 values were corrected.Results:178 postoperative pneumonia cases were found which the incidence rate of infection was 20.23%.11 variables were found related to infection by univariate analysis:age,blood loss,blood transfusion,emergency surgery,tracheotomy,nasogastric tube indwelling,preoperative underlying diseases,ASA score,operation duration,preoperative hospitalized days.7 variables were found as independent risk factors associated to postoperative pneumonia by multivariate logistic regression modeling which is ranked descendantly by OR values:tracheotomy(OR=27.727,95%CI:2.493-308.348),nasogastric tube indwelling(OR=4.550,95%CI:2.537-8.161),emergency surgery(OR=4.339,95%CI:1.490-12.631),mechanical ventilation duration?4h(OR=2.806,95%CI:1.369-5.75),preoperative hospitalized days(OR=1.055,95%CI:1.016-1.095),age(OR=1.027,95%CI:1.013-1.042),operation duration(OR=1.004,95%CI:1.002-1.005).Conclusions:The high incidence rate of postoperative pneumonia was associated to multi-factors:preoperative underlying diseases,trancheotomy,mechanical ventilation duration,nasogastric tube indwelling,emergency surgery,ASA score,blood loss,blood transfusion,long operation duration,eldly,long preoperative hospitalized stay.The independent risk factors were trancheotomy,nasogastric tube indwelling,emergency surgery,mechanical ventilation duration,long operation duration,eldly,and long preoperative time.Multi-prevention strategies were very important to decrease incidence rate of postoperative pneumonia.