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Deep Brain Stimulation-Related Infections: Analysis of Rates, Timing, and Seasonality
Fran A Hardaway1, Ahmed M Raslan1, Kim J Burchiel1
1Department of Neurological Surgery, Oregon Health & Sciences University, Portland, Oregon.
Background:
Infection is one of the most common complications of deep brain stimulation (DBS). Long-term infection rates beyond the immediate postoperative period are rarely evaluated.
Objective:
To study short- and long-term DBS-related infection rates; to evaluate any potential seasonality associated with DBS-related infections.
Methods:
We retrospectively reviewed all DBS surgeries performed in a 5-yr period at 1 hospital by a single surgeon. Infection rates and clinical characteristics were analyzed. Postoperative "infections" were defined as occurring within 6 mo of implantation of DBS hardware, while "erosions" were defined as transcutaneous exposure of hardware at ≥6 mo after implantation. Based on the date of surgery preceding an infection, rates of infection were calculated on a monthly and seasonal basis and compared using Chi square and logistic regression analyses.
Results:
A total of 443 patients underwent 592 operations; 311 patients underwent primary DBS placement with 632 electrodes. Primary DBS placement infection incidence was 2.6%. DBS procedure infection and infection rate by electrode were 2.9% and 3.2%, respectively. Infectious complications presented later than 6 mo postoperatively in 38% of infected patients Summer (July-September) infection rate was significantly higher than other seasons (P = .002). The odds ratio of an infection related to a surgery performed in August was found to be 4.15 compared to other months (P = .021).
Conclusion:
There is a persistent risk of DBS infection and erosion beyond the first year of DBS implantation. Start of the academic year was associated with increased infection rate at our institution.
Insights
Deep brain stimulation (DBS) infections can occur long-term, with a higher risk during summer months. The start of the academic year was also linked to increased infection rates in patients.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Medical Device Complications
Background:
- Infection is a frequent complication of deep brain stimulation (DBS).
- Long-term infection rates following DBS surgery are seldom investigated.
- Evaluating infection risk beyond the immediate postoperative period is crucial for patient management.
Purpose of the Study:
- To determine short- and long-term infection rates associated with deep brain stimulation (DBS).
- To assess any seasonal patterns in the occurrence of DBS-related infections.
- To identify potential risk factors for late-onset DBS infections.
Main Methods:
- Retrospective review of 592 deep brain stimulation (DBS) surgeries over a 5-year period.
- Analysis of infection rates, defining early (<6 months) and late (≥6 months) complications.
- Statistical comparison of infection rates based on month and season of surgery.
Main Results:
- The overall incidence of deep brain stimulation (DBS) infection was 2.6% for primary placement.
- 38% of infectious complications occurred more than 6 months postoperatively.
- Infection rates were significantly higher during summer (July-September) and in August specifically.
Conclusions:
- Deep brain stimulation (DBS) carries a persistent risk of infection and erosion beyond the first year.
- The timing of surgery, particularly during summer and the start of the academic year, may influence infection risk.
- Further research is needed to understand and mitigate long-term DBS infection risks.
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