Nomogram for Predicting the Risk of Post-Craniotomy Intracranial Infection in Patients With Brain Tumors.

Area of Science:

• Neurosurgery
• Infectious Disease Epidemiology
• Biostatistics

Background:

• Post-craniotomy intracranial infection (PCII) is a significant risk for brain tumor patients.
• Accurate prediction of PCII is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To develop and validate a nomogram model for predicting the risk of PCII in patients undergoing brain tumor surgery.
• To identify key risk factors associated with PCII development.

Main Methods:

• Retrospective analysis of 968 brain tumor patients' data (Jan 2021-Dec 2023).
• Multifactorial analysis, including multivariate Cox regression and AIC, to identify PCII risk factors.
• Nomogram construction and validation using C-index, AUC, and calibration curves for predictions at -3, -7, and -14 days post-surgery.

Main Results:

• The incidence of PCII was 12.40% (120/968 patients).
• Nine significant PCII risk factors were identified: BMI, surgical duration, preoperative albumin, hypertension, diabetes, drainage tube, subtentorial location, CSF leakage, and intraoperative blood loss (≥400 mL).
• The nomogram achieved a C-index of 0.876, with AUCs of 0.787, 0.842, and 0.873 at -3, -7, and -14 days, respectively, demonstrating good predictive accuracy and calibration.

Conclusions:

• A validated nomogram effectively predicts PCII risk in brain tumor patients.
• The nomogram facilitates personalized risk assessment and management strategies for PCII prevention.