Table 1.
Baseline characteristics and outcomes of patients undergoing craniotomy in the two study periods
| Pre-care bundle period (n = 595) |
Care bundle period (n = 422) |
p value | |||
|---|---|---|---|---|---|
| Baseline characteristics | |||||
| Male, n (%) | 274 | (54.6) | 228 | (45.4) | 0.013 |
| Median age, years (IQR) | 54 | (21) | 55 | (22) | 0.143 |
| Urgent surgery, n (%) | 79 | (13.3) | 54 | (12.8) | 0.851 |
| Reason for surgery | |||||
| Intrinsic tumour, n (%) | 234 | (39.3) | 181 | (42.9) | 0.271 |
| Extrinsic tumour, n (%) | 123 | (20.7) | 105 | (24.9) | 0.127 |
| Epilepsy, n (%) | 23 | (3.9) | 8 | (1.9) | 0.095 |
| Vascular, n (%) | 152 | (25.5) | 100 | (23.7) | 0.508 |
| Trauma, n (%) | 17 | (2.9) | 20 | (4.7) | 0.127 |
| Others, n (%) | 46 | (7.7) | 8 | (1.9) | < 0.001 |
| Surgical site | |||||
| Supratentorial, n (%) | 449 | (75.5) | 363 | (86) | < 0.001 |
| Infratentorial, n (%) | 62 | (10.4) | 29 | (6.9) | 0.05 |
| Retromastoid, n (%) | 84 | (14.1) | 30 | (7.1) | < 0.001 |
| Duration of surgery: minutes, median (IQR) | 243 | (130) | 260 | (136.5) | 0.08 |
| CHARLSON score, median (IQR) | 3 | (2) | 3 | (2) | 0.8 |
| ASA > 2 | 223 | (37.5) | 127 | (30.1) | 0.08 |
| Inappropriate antibiotic prophylaxis, n (%) | 83 | (13.9) | 106 | (25.1) | < 0.001 |
| CSF leak, n (%) | 11 | (1.8) | 3 | (0.7) | 0.173 |
| ICP sensor, n (%) | 36 | (6.1) | 23 | (5.4) | 0.786 |
| Use of steroids/chemotherapy, n (%) | 439 | (73.8) | 377 | (89.3) | < 0.001 |
| Mean hospital 1 year stay, median (IQR) | 10 | (19) | 9.5 | (16.2) | 0.338 |
| Outcomes | |||||
| Primary outcome | |||||
| SSI-CRAN1, n (%) | 91 | (15.3) | 15 | (3.5) | < 0.001 |
| Occurrence of SSI-CRAN, days (IQR2) | 21 | (14–43) | 19 | (17.5–39.5) | 0.06 |
| Detection | |||||
| During hospital admission, n (%) | 31 | (34.1) | 5 | (33.3) | 1 |
| Post-discharge surveillance, n (%) | 11 | (12.1) | 0 | 0.357 | |
| Readmission, n (%) | 49 | (53.8) | 10 | (66.7) | 0.411 |
| SSI-CRAN classification | |||||
| Superficial incisional, n (%) | 8 | (8.8) | 2 | (13.3) | 0.777 |
| Deep incisional, n (%) | 16 | (17.6) | 3 | (20) | 0.730 |
| Organ-space, n (%) | 67 | (73.6) | 10 | (66.7) | 0.548 |
| Secondary SSI-CRAN Outcomes | (n = 91) | (n = 15) | |||
| 1-year mortality, n (%) | 2 | (2.2) | 0 | (0) | 1 |
| Re-intervention, n (%) | 72 | (79.1) | 13 | (86.7) | 0.730 |
| Number of re-interventions, median (IQR) | 1.4 | (1.1) | 1.4 | (0.9) | 0.891 |
| Implant for cranial reconstruction | 27 | (29.7) | 3 | (20) | 0.548 |
| Days of antibiotic therapy, median (IQR) | 37.8 | (29.9) | 35 | (22.2) | 0.764 |
| Cumulative days of antibiotic therapy, days | 3438 | 525 | < 0.001 | ||
| MDR3 microorganism infection, n (%) | 16 | (17.6) | 3 | (20) | 0.730 |
ASA American Society of Anesthesiologists, CSF cerebrospinal fluid, ICP intracranial pressure, IQR interquartile range, MDR multidrug-resistant, SSI-CRAN surgical site infection after craniotomy