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Table 2 Results of univariate and unadjusted logistic regression analyses for variables of case background and perioperative factors in SSIs after shunt surgery

From: Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study

  Total (N = 323) Case without SSI (N = 309) Case with SSI (N = 14) Unadjusted logistic regression
n % n % n % Odds ratio 95% CI p -value
Female 129 39.9 212 68.6 9 64.3 1.20 0.39–3.69 0.74
Age(Month), median (IQR) 139 (33, 202) 131 (33, 198) 170 (145, 209) 1.00 1.00–1.01 0.16
Age          0.17*
  < 1y 43 13.3 41 13.3 2 14.3 (base)   
 1-2y 50 15.5 49 15.9 1 7.1 0.42 0.03–4.78 0.48
 3-10y 60 18.6 60 19.4 0 0.0    
 11-18y 123 38.1 114 36.9 9 64.3 1.62 0.33–7.80 0.55
 18y- 47 14.6 45 14.6 2 14.3 0.91 0.12–6.77 0.93
Weight(kg), median (IQR) 33.6 (12.7, 58.2) 32.6 (12.4, 57.8) 49.8 (35.0, 58.6) 1.01 0.99–1.02 0.38
ASA Classification          
 Class ≤ II 78 24.1 75 24.3 3 21.4 (base)   
 Class ≥ III 245 75.9 234 75.7 11 78.6 1.18 0.32–4.32 0.81
Wound Class          1.00*
 1: Clean 320 99.1 306 99.0 14 100.0    
 2: Clean-Contaminated 3 0.9 3 1.0 0 0.0    
 3: Contaminated 0 0.0 0 0.0 0 0.0    
 4: Dirty/Infected 0 0.0 0 0.0 0 0.0    
Comorbidity
 Brain tumor 93 28.8 87 28.2 6 42.9 1.91 0.65–5.68 0.24
 Cardiac disease 9 2.8 7 2.3 2 14.3 7.19 1.35–38.35 0.02
 Gastrostomy status 63 19.5 58 18.8 5 35.7 2.40 0.78–7.44 0.13
 Prematurity (GA < 37 week) 6 1.9 6 1.9 0 0.0    1.00*
Procedure          1.00*
 V-P shunt 306 94.7 292 94.5 14 100.0    
 V-A shunt 7 2.2 7 2.3 0 0.0    
 L-P shunt 10 3.1 10 3.2 0 0.0    
Number of shunt revision, mean (SD) 1 (2,4) 2 (1,4) 3 (1,6) 1.12 0.99–1.27 0.07
Emergent surgery 198 61.3 190 61.5 8 57.1 0.84 0.28–2.47 0.74
Duration of surgery(min), median(IQR) 77 (56, 108) 77 (56, 108) 76 (60, 96) 1.00 0.99–1.01 0.92
Prophylactic antibiotics 320 99.1 306 99.0 14 100.0   1.00*
 Cefazolin 274 84.8 264 85.4 10 71.4 0.43 0.13–1.42 0.16
 Ampicillin 1 0.3 1 0.3 0 0.0    1.00*
 Cefoxitin 1 0.3 1 0.3 0 0.0    1.00*
 Ciprofloxacin 4 1.2 4 1.3 0 0.0    1.00*
 Cefepime 5 1.5 4 1.3 1 7.1 5.87 0.61–56.2 0.13
 Ceftazidime 1 0.3 1 0.3 0 0.0    1.00*
 Ceftriaxone 5 1.5 5 1.6 0 0.0    1.00*
 Clindamycin 19 5.9 16 5.2 3 21.4 4.99 1.27–19.70 0.02
 Metronidazole 0 0.0 0 0.0 0 0.0    
 Vancomycin 23 7.1 21 6.8 2 14.3 2.29 0.48–10.89 0.3
 Meropenem 3 0.9 3 1.0 0 0.0    1.00*
Surgeon n = 10    0.54*
Skin preparation agent          0.93*
 None 36 11.1 35 11.3 1 7.1 (base)   
 CHG-alcohol(Chloraprep™) 235 72.8 224 72.5 11 78.6 1.72 0.22–13.72 0.61
 Povidone-iodine 17 5.3 16 5.2 1 7.1 2.19 0.13–37.22 0.59
 Povidone-iodine and CHG-alcohol 5 1.5 5 1.6 0 0.0    
 Povidone-iodine and alcohol 28 8.7 27 8.7 1 7.1 1.30 0.08–21.68 0.86
 CHG, alcohol, and povidone-iodine 2 0.6 2 0.6 0 0.0    
Average temperature (°C), median (IQR) 36.0 (35.6, 36.4) 36.0 (35.6, 36.4) 35.1 (35.1, 35.1) 0.18 0.01–2.93 0.23
Minimum temperature(°C), median (IQR) 35.4 (34.8, 35.9) 35.4 (34.8, 35.9) 34.9 (34.9, 34.9) 0.44 0.03–7.06 0.56
Propofol (mg/kg), median(IQR)a 2.9 (2.0, 4.7) 2.9 (1.4, 3.8) 3.0 (2.1, 6.3) 1.00 0.91–1.10 0.96
ET sevoflurane, median(IQR)a 192 (102, 293) 192 (102, 298) 172 (116, 253) 1.00 0.996–1.003 0.78
ET isoflurane, median(IQR)a 0 (0, 0) 0 (0, 0) 0 (0, 0) 0.99 0.97–1.01 0.29
O2 flow, median(IQR)a 347 (272, 440) 347 (271, 451) 340 (278, 425) 1.00 0.996–1.004 0.99
  1. SSIs surgical site infection, IQR interquartile range, ASA American Society of Anesthesiologists physical status classification, GA gestational age, V-P ventriculo-peritoneal, EVD external ventricular drain, ETV endoscopic third ventriculostomy, V-A ventriculo-atrial, L-P Lumbo-peritoneal, SD standard deviation, ET end tidal, CHG chlorhexidine gluconate
  2. *Univariate analysis was performed
  3. aThe amount of milligram per kilogram of body weight was calculated for intravenous drugs, and the end tidal concentration per minute for volatile anesthetics or oxygen was summed up by the anesthesia duration (minutes)