Risk factors in patients treated with surgical drainage for rhinogenic intracranial complications: a nationwide study

Data on risk factors for rhinogenic intracranial complications (RICs) including cerebral abscess have been limited. Using a nationwide database, the aim was to identify the factors related to mortality and delayed discharge.

Data of 326 patients between 2012 and 2022 were extracted from a Japanese inpatient database. The main outcome was survival at discharge. In a subgroup analysis of the 316 surviving patients, the outcome was delayed discharge.

The mortality rate was 3.1%. Logistic regression analyses identified intracerebral complications more than one surgical intervention and consciousness level evaluated by the Japan Coma Scale (JCS): JCS I and JCS ≥ II as risk factors for mortality. Concurrent interventions of intracranial and sinonasal drainage was identified as a factor associated with decreased risk.

Although RICs are rare, with decreasing mortality due to progress in imaging and clinical strategies, they remain the most severe complications of rhinosinusitis. Subdural and/or intracerebral abscess, consciousness level at admission, and more than one surgical intervention were found to be risk factors for mortality. Conversely, concurrent interventions, intracranial and sinonasal drainage, contributed to reducing this risk.