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Risk Factors for Brain Abscess: A Nationwide, Population-Based, Nested Case-Control Study.

Jacob Bodilsen1, Michael Dalager-Pedersen1,2, Diederik van de Beek3

  • 1Department Infectious Diseases, Aalborg, Denmark.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 24, 2019
PubMed
Summary

Neurosurgery, cancer, and ENT infections are key risk factors for brain abscess. Immunomodulating treatments also increase risk, highlighting areas for targeted prevention strategies.

Keywords:
brain abscesscase-controlpopulation attributable riskpopulation-basedrisk factor

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Epidemiology

Background:

  • Knowledge regarding brain abscess risk factors is limited, primarily based on single-center studies.
  • A population-based study is needed to identify comprehensive risk factors for brain abscess.

Purpose of the Study:

  • To conduct a population-based, nested case-control study to identify risk factors for brain abscess.
  • To calculate population-attributable fractions for significant risk factors.

Main Methods:

  • Utilized nationwide medical registries for a population-based, nested case-control study.
  • Employed risk-set sampling for population controls (1:10), matched by age, sex, and residence.
  • Applied conditional logistic regression to determine adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Main Results:

  • Identified 1384 brain abscess patients and 13,839 matched controls in Denmark (1982-2016).
  • Significant risk factors included neurosurgery (aOR 19.3), dental infections (aOR 4.61), ENT infections (aOR 3.81), and various cancers (aORs 4.12-8.77).
  • Neurosurgery (12%), solid cancer (11%), ENT infections (7%), and immunomodulating treatments (5%) were substantial contributors to brain abscess incidence.

Conclusions:

  • Neurosurgery, cancer, ear, nose, and throat infections, and immunomodulating treatments are critical risk factors for brain abscess.
  • These findings provide crucial insights for developing targeted prevention and management strategies for brain abscess.