Clinical experience summary and analysis of the patients with intracranial infection secondary to brain injury

Abstract

Objective To summary and analyze the clinical characteristics and acute phase prognosis of brain injury patients complicated by intracranial infection.Methods The clinical data of brain injury patients with intracranial infection confirmed by cerebrospinal fluid culture in Huashan hospital trauma center during January 2008 to December 2012 were collected and retrospectively analyzed.Risk factors of Glasgow coma scale (GCS) at discharge,multiple microbial infection and G-/G+ infection were investigated.Results From January 2008 to December 2012 there are 82 patients with intracranial infection secondary to brain injury.Total of 97 bacterial strains were identified by CSF culture,of which A.Baumannii was the most common pathogenic bacteria (28.9％).GCS at admission (OR:7.44,95％ CI:2.80-19.76,P ＜0.0001),extra-ventricular drainage(EVD) (OR:0.31,95％ CI:0.12-0.79,P =0.0220),G-infection (OR:0.21,95％ CI:0.07-0.62,P =0.0062) and pneumonia (OR:0.33,95％ CI:0.12-0.85,P =0.0352) were the main risk factors for poor GCS at discharge; there was significant difference in in-hospital mortality (OR:10.95,95％ CI:0.6234-192.2,P =0.0327) between G-and G + bacterial infectious group; hospital expense was higher in patients with intracranial infections caused by multiple bacterial species than that caused by single bacterial species (P =0.0347).Conclusions Low GCS at admission,EVD,G infection and pneumonia were the risk factors associated with the low GCS at discharge.Intracranial infection caused by G bacterial was the high risk factor for inhospital mortality.Active treatment should be adopted for those patients at high risk to lower the mortality and morbidity,alleviating their financial burden. Key words: Craniocerebral trauma; Cerebral hemorrhage; Central nervous system infections; Risk factor