Invasive procedures and risk of brain abscess: a nationwide, population-based case-control study

Lars Haukali Omland*, Jacob Bodilsen, Jannik Helweg-Larsen, Jens Otto Jarløv, Kristian Andreasen, Morten Ziebell, Svend Ellermann-Eriksen, Ulrik S Justesen, Niels Frimodt-Møller, Niels Obel

*Corresponding author for this work


OBJECTIVES: It is unknown whether invasive procedures are associated with brain abscess.

METHODS: Nationwide, population-based, matched case-control study of patients with culture verified brain abscess in Denmark from 1989 to 2016. Exposure was invasive procedures 0-6 months before study inclusion.

RESULTS: We identified 435 patients and 3909 controls. The level of comorbidity was higher among patients with brain abscess than among controls. A total of 48 cases (11%) had one or more invasive procedures 0-6 months before study inclusion (adjusted odds ratios (aOR) of 3.6 (95% confidence interval (CI): 2.5-5.1), a population attributable fractions of 8% (95% CI: 7-9)). In primary care, ear, nose and throat (ENT) procedures were associated with brain abscess (aOR of 4.0 (95% CI: 2.0-8.0)), but gastrointestinal endoscopies were not (aOR of 1.0 (95% CI: 0.3-3.2)). No bronchoscopies were performed in primary care. In the hospital-based setting, ENT procedures, bronchoscopies and gastrointestinal endoscopies were associated with an increased risk of brain abscess (aOR of 14.5 (95% CI: 4.8-43.8), 20.3 (95% CI: 3.8-110.1) and 3.4 (95% CI: 2.0-5.6), respectively).

CONCLUSIONS: The association between invasive procedures and brain abscess was more pronounced in the hospital-based setting than in primary care.

Original languageEnglish
JournalInfectious diseases (London, England)
Issue number1
Pages (from-to)55-62
Number of pages8
Publication statusPublished - 2023


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