Short- and Long-Term Risk of Meningitis Following Pediatric Endoscopic Transsphenoidal Surgery.

Area of Science:

• Pediatric Neurosurgery
• Skull Base Surgery
• Infectious Disease Risk

Background:

• Transsphenoidal skull base surgery is performed in children and adolescents.
• Postoperative meningitis is a potential complication.
• Understanding short- and long-term risks is crucial for patient management.

Purpose of the Study:

• To determine the short- and long-term risks of meningitis in pediatric patients undergoing transsphenoidal skull base surgery.
• To identify risk factors for postoperative meningitis in this population.

Main Methods:

• Retrospective analysis of the Pediatric Health Information System (PHIS) database (2012-2022).
• Inclusion of patients ≤ 18 years undergoing endoscopic transsphenoidal surgery.
• Analysis of readmissions to identify meningitis cases and associated risk factors.

Main Results:

• 476 patients (501 cases) were analyzed; 5.0% developed meningitis.
• Meningitis occurred in 2.7% during initial hospitalization and 2.3% post-discharge (mean 8.1 months).
• Younger age (< 12 years) was the only identified risk factor; meningitis patients had longer hospital stays.

Conclusions:

• Short-term meningitis risk in pediatric patients is comparable to adults.
• Long-term meningitis risk is low, typically occurring within one year post-discharge.
• Prophylactic antibiotics should be considered for patients under 12 years undergoing this surgery.