TY  - BOOK
AU  - Cobourn, Kelsey
AU  - Dowlati, Ehsan
TI  - A cross-sectional analysis of variables associated with morbidity and mortality in postoperative neurosurgical patients diagnosed with sepsis
SN  - 0001-6268
PY  - 2020///
KW  - *Neurosurgical Procedures/ae [Adverse Effects]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - *Sepsis/ep [Epidemiology]
KW  - Adult
KW  - Aged
KW  - Female
KW  - Humans
KW  - Length of Stay/sn [Statistics & Numerical Data]
KW  - Male
KW  - Middle Aged
KW  - Morbidity
KW  - Mortality
KW  - Patient Readmission/sn [Statistics & Numerical Data]
KW  - Postoperative Complications/et [Etiology]
KW  - Postoperative Complications/mo [Mortality]
KW  - Sepsis/et [Etiology]
KW  - Sepsis/mo [Mortality]
KW  - MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Journal Article
N2  - BACKGROUND: Sepsis is a systemic, inflammatory response to infection associated with significant morbidity and mortality. There is a considerable lack of literature exploring sepsis in neurosurgery. We aimed to identify variables that were correlated with mortality and increased morbidity as defined by readmission and increased length of stay in postoperative neurosurgical patients that met a sepsis diagnosis; CONCLUSIONS: Neurosurgical postoperative patients diagnosed with sepsis may be risk stratified for mortality, readmission, and increased length of stay based on certain variables that may help direct their care. Further prospective studies are needed to explore causal relationships; METHODS: A retrospective chart review was conducted of 105 patients who underwent a neurosurgical operation at our institution from 2012 to 2017 who were discharged with at least one sepsis diagnosis code and who did not have a preoperative infection. We identified variables that were correlated with mortality, readmission, and increased length of stay; RESULTS: Patients who survived were preferentially distributed towards lower ASA Physical Status Classification scores. A larger percentage of patients who did not survive had cranial surgery, whereas patients who survived were more likely to have undergone spinal surgery. Higher respiratory rates, higher maximum lactic acid levels, positive sputum cultures, and lower incoming Glasgow Coma Scores (GCS) were significantly correlated with mortality. A larger fraction of readmitted patients had positive surgical site cultures but had negative sputum cultures. Length of hospitalization was correlated with incoming GCS, non-elective operations, and Foley catheter, arterial line, central line, and endotracheal tube duration
UR  - https://dx.doi.org/10.1007/s00701-020-04586-1
ER  -