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The factors involved in deep brain stimulation infection: a large case series
Christopher Tolleson1, Jessica Stroh, Jesse Ehrenfeld
1Vanderbilt University Hospital, Nashville, Tenn., USA.
Background:
Deep brain stimulation (DBS) is a proven treatment for various movement disorders resistant to medical management. Complications such as postsurgical infection can negate benefits and increase patient morbidity. We sought to better define risk factors for infection.
Methods:
We performed a review of DBS cases at our institution from January 1996 to June 2011. Information on multiple metrics including surgical complications, procedural complications and infection were entered into a secure online database.
Results:
A total of 447 patients received DBS surgery. Twenty-six (5.82%) developed infection sometime after DBS surgery with 9 (2.01%) developing infection within 30 days after the final staged surgery. Operating surgeon (p = 0.012), scalp erosion (p = 0.0001), surgical incision opening time (0.0001) and number of individuals in the operating room (0.0027) were significant in the cumulative infection group.
Conclusion:
The 30-day infection rate was comparably low to other published studies. Several factors were noted to be significant in the cumulative infection group, but none in the 30-day infection group. Further understanding of infection risk factors is important to optimize patient selection and standardize infection-preventative techniques.
Insights
Deep brain stimulation (DBS) surgery has a low 30-day infection rate. However, cumulative infection risk is influenced by factors like operating surgeon and surgical site complications.
Area of Science:
- Neurosurgery
- Infectious Disease Epidemiology
Background:
- Deep brain stimulation (DBS) is an established treatment for refractory movement disorders.
- Postsurgical infections pose a significant risk, potentially undermining treatment efficacy and increasing patient morbidity.
Purpose of the Study:
- To identify and define risk factors associated with postsurgical infections following DBS procedures.
Main Methods:
- A retrospective review of 447 DBS cases performed between January 1996 and June 2011.
- Data collected included surgical and procedural complications, with a specific focus on infection development.
- Information was systematically entered into a secure online database for analysis.
Main Results:
- Overall, 5.82% of patients developed an infection post-DBS, with 2.01% occurring within 30 days of the final surgery.
- Significant risk factors for cumulative infection included the operating surgeon (p=0.012), scalp erosion (p=0.0001), prolonged surgical incision opening time (p=0.0001), and the number of operating room personnel (p=0.0027).
- No significant risk factors were identified for infections occurring within the 30-day postoperative period.
Conclusions:
- The 30-day infection rate following DBS is comparable to existing literature.
- Several factors are associated with cumulative infection risk, highlighting areas for targeted prevention strategies.
- Further research into infection risk factors is crucial for optimizing patient selection and standardizing infection control techniques in DBS surgery.
