CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold

Anna Boethun; Nadja Hawwa Vissing; René Mathiasen; Jane Skjøth-Rasmussen; Jon Foss-Skiftesvik

doi:10.1007/s00381-022-05799-8

CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold

Anna Boethun^*, Nadja Hawwa Vissing, René Mathiasen, Jane Skjøth-Rasmussen, Jon Foss-Skiftesvik^*

^*Corresponding author for this work

1 Citation (Scopus)

Abstract

PURPOSE: To investigate the risk of central nervous system (CNS) infections in children undergoing neurosurgery for brain tumors.

METHODS: Single-center retrospective cohort study including all children with brain tumors undergoing neurosurgical treatment over an 11-year period.

RESULTS: A total of 274 patients undergoing 733 neurosurgical procedures were included. Overall, 12.8% of patients were diagnosed with a CNS infection during their course of treatment. CNS infections were more frequent among children treated with CSF diversion (p < 0.001) and independently associated with low age (OR/y 0.9 (CI 95% 0.769-0.941), intraventricular (OR 2.8, CI 95% 1.2-6.5), and high-grade tumors (OR 2.7, CI 95% 1.1-6.5). The majority of CNS infections occurred within 30 days of surgery, resulting in a postoperative CNS infection rate of 5.3%. Postoperative CNS infections were significantly more frequent following adjunct EVD placement during tumor resection compared to a stand-alone craniotomy (30.4% vs. 1.5%, RR 20.6, CI 95% 5.7-72.2).

CONCLUSION: CNS infections affect at least 12% of children with brain tumors and are associated with age, tumor location, and grade. Adding EVD to tumor surgery increases the risk of postoperative CNS infection, and reconsidering routine adjunct EVD placement is therefore advocated.

Original language	English
Journal	Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
Volume	39
Issue number	2
Pages (from-to)	387-394
Number of pages	8
ISSN	0256-7040
DOIs	https://doi.org/10.1007/s00381-022-05799-8
Publication status	Published - Feb 2023

Keywords

Extraventricular drainage
Pediatric brain tumors
Postoperative infection
Ventriculitis
Drainage/methods
Humans
Ventriculostomy/methods
Central Nervous System Infections
Nervous System Malformations
Brain Neoplasms
Craniotomy
Retrospective Studies
Child

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Boethun, A., Vissing, N. H., Mathiasen, R., Skjøth-Rasmussen, J., & Foss-Skiftesvik, J. (2023). CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 39(2), 387-394. https://doi.org/10.1007/s00381-022-05799-8

CNS infection in children with brain tumors : adding ventriculostomy to brain tumor resection increases risk more than 20-fold. / Boethun, Anna; Vissing, Nadja Hawwa; Mathiasen, René et al.

In: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, Vol. 39, No. 2, 02.2023, p. 387-394.

Research output: Contribution to journal › Journal article › Research › peer-review

Boethun, A, Vissing, NH, Mathiasen, R, Skjøth-Rasmussen, J & Foss-Skiftesvik, J 2023, 'CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold', Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, vol. 39, no. 2, pp. 387-394. https://doi.org/10.1007/s00381-022-05799-8

Boethun A, Vissing NH, Mathiasen R, Skjøth-Rasmussen J , Foss-Skiftesvik J. CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold. Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 2023 Feb;39(2):387-394. https://doi.org/10.1007/s00381-022-05799-8

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abstract = "PURPOSE: To investigate the risk of central nervous system (CNS) infections in children undergoing neurosurgery for brain tumors.METHODS: Single-center retrospective cohort study including all children with brain tumors undergoing neurosurgical treatment over an 11-year period.RESULTS: A total of 274 patients undergoing 733 neurosurgical procedures were included. Overall, 12.8% of patients were diagnosed with a CNS infection during their course of treatment. CNS infections were more frequent among children treated with CSF diversion (p < 0.001) and independently associated with low age (OR/y 0.9 (CI 95% 0.769-0.941), intraventricular (OR 2.8, CI 95% 1.2-6.5), and high-grade tumors (OR 2.7, CI 95% 1.1-6.5). The majority of CNS infections occurred within 30 days of surgery, resulting in a postoperative CNS infection rate of 5.3%. Postoperative CNS infections were significantly more frequent following adjunct EVD placement during tumor resection compared to a stand-alone craniotomy (30.4% vs. 1.5%, RR 20.6, CI 95% 5.7-72.2).CONCLUSION: CNS infections affect at least 12% of children with brain tumors and are associated with age, tumor location, and grade. Adding EVD to tumor surgery increases the risk of postoperative CNS infection, and reconsidering routine adjunct EVD placement is therefore advocated.",

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T2 - adding ventriculostomy to brain tumor resection increases risk more than 20-fold

AU - Boethun, Anna

AU - Vissing, Nadja Hawwa

AU - Mathiasen, René

AU - Skjøth-Rasmussen, Jane

AU - Foss-Skiftesvik, Jon

PY - 2023/2

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N2 - PURPOSE: To investigate the risk of central nervous system (CNS) infections in children undergoing neurosurgery for brain tumors.METHODS: Single-center retrospective cohort study including all children with brain tumors undergoing neurosurgical treatment over an 11-year period.RESULTS: A total of 274 patients undergoing 733 neurosurgical procedures were included. Overall, 12.8% of patients were diagnosed with a CNS infection during their course of treatment. CNS infections were more frequent among children treated with CSF diversion (p < 0.001) and independently associated with low age (OR/y 0.9 (CI 95% 0.769-0.941), intraventricular (OR 2.8, CI 95% 1.2-6.5), and high-grade tumors (OR 2.7, CI 95% 1.1-6.5). The majority of CNS infections occurred within 30 days of surgery, resulting in a postoperative CNS infection rate of 5.3%. Postoperative CNS infections were significantly more frequent following adjunct EVD placement during tumor resection compared to a stand-alone craniotomy (30.4% vs. 1.5%, RR 20.6, CI 95% 5.7-72.2).CONCLUSION: CNS infections affect at least 12% of children with brain tumors and are associated with age, tumor location, and grade. Adding EVD to tumor surgery increases the risk of postoperative CNS infection, and reconsidering routine adjunct EVD placement is therefore advocated.

AB - PURPOSE: To investigate the risk of central nervous system (CNS) infections in children undergoing neurosurgery for brain tumors.METHODS: Single-center retrospective cohort study including all children with brain tumors undergoing neurosurgical treatment over an 11-year period.RESULTS: A total of 274 patients undergoing 733 neurosurgical procedures were included. Overall, 12.8% of patients were diagnosed with a CNS infection during their course of treatment. CNS infections were more frequent among children treated with CSF diversion (p < 0.001) and independently associated with low age (OR/y 0.9 (CI 95% 0.769-0.941), intraventricular (OR 2.8, CI 95% 1.2-6.5), and high-grade tumors (OR 2.7, CI 95% 1.1-6.5). The majority of CNS infections occurred within 30 days of surgery, resulting in a postoperative CNS infection rate of 5.3%. Postoperative CNS infections were significantly more frequent following adjunct EVD placement during tumor resection compared to a stand-alone craniotomy (30.4% vs. 1.5%, RR 20.6, CI 95% 5.7-72.2).CONCLUSION: CNS infections affect at least 12% of children with brain tumors and are associated with age, tumor location, and grade. Adding EVD to tumor surgery increases the risk of postoperative CNS infection, and reconsidering routine adjunct EVD placement is therefore advocated.

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KW - Nervous System Malformations

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JF - Child's Nervous System

SN - 0256-7040

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ER -

CNS infection in children with brain tumors: adding ventriculostomy to brain tumor resection increases risk more than 20-fold

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