OBJECTIVE To explore the risk factors for surgical site infection （SSI） after craniotomy for intracranial tumors and quantify their impact on hospital stay and medical costs, so as to provide references for precise perioperative infection prevention and control.
METHODS A retrospective analysis was conducted on the clinical data of 4 858 patients who underwent craniotomy for intracranial tumors at the First Medical Center of Chinese PLA General Hospital from Jan. 1, 2019 to Dec. 31, 2024, including 79 infected patients. The risk factors for SSI were summarized with a multivariate logistic regression model. The comparison of hospital stay and costs between infected and non-infected patients was performed after 1∶1 matching through propensity score matching （PSM）.
RESULTS The incidence rate of SSI was 1.63% （79/4 858）. Male gender （OR=2.509, 95%CI: 1.554−4.052）, having ≥3 comorbidities （OR=3.599, 95%CI: 2.239−5.785）, surgical sites ≥2 （OR=1.792, 95%CI: 1.049−3.060）and surgical duration ＞4 h （OR=5.366, 95%CI: 1.944−14.811） were the risk factors for postoperative infections, the use of antibacterial agents 0.5 h to 2 h before surgery （OR=0.194, 95%CI: 0.047−0.795）was protective factors. After 1∶1 matching based on the PSM method, the median hospital stay in the infected group was prolonged by 11.08 days （P＜0.001）, and the median total cost increased by 45.68% （112 872 vs. 77 479 yuan, P＜0.001）, with a 227.81% increase in medication costs.
CONCLUSIONS Surgical duration, male, multiple comorbidities and multi-site surgeries are risk factors for SSI, while the use of antibacterial agents 0.5 h to 2 h before surgery is a protective factor. SSI significantly increases medical costs and hospital stay, and stratified prevention and control measures targeting high-risk populations can reduce clinical economic burdens.
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