Correlations of cerebrospinal fluid routines and biochemical indexes before ventriculoperitoneal shunt with postoperative intracranial infection in adult patients with hydrocephalus / 中华神经医学杂志

ABSTRACT

Objective:To study the correlations of cerebrospinal fluid (CSF) routines and biochemical indexes before ventriculoperitoneal shunt with postoperative intracranial infection in adult patients with hydrocephalus.Methods:A retrospective case-control study was conducted on 347 adult patients who underwent ventriculoperitoneal shunt in Department of Functional Neurosurgery, Neurosurgery Center, Zhujiang Hospital of Southern Medical University from January 2016 to December 2021. According to the appearance of postoperative infection or not, these patients were divided into infection group ( n=27) and non-infection group ( n=320). General clinical data and CSF routines and biochemical indexes test results were analyzed and compared between the two groups. The correlations of postoperative intracranial infection with preoperative levels of white blood cells, chlorine, glucose, lactic acids and proteins in the CSF were analyzed by multivariate Logistic regression. Results:There was no significant difference in age, gender, or primary diseases between infection group and non-infection group ( P>0.05). As compared with the non-infection group, the infection group had significantly decreased glucose content and significantly increased lactic acid content in the CSF ( P<0.05). Multivariate Logistic regression analysis showed that glucose content ( OR=21.825, 95%CI: 4.994-95.394, P<0.001) and lactic acid content ( OR=18.430, 95%CI: 6.023-56.391, P<0.001) were independently correlated with infections after ventriculoperitoneal shunt. Risk of patients with glucose content<2.5 to develop intracranial infection after surgery was 21.825 times that of patients with preoperative glucose content≥2.5 mmol/L. Risk of patients with lactic acid content>2.5 mmol/L to develop intracranial infection after surgery was 18.430 times that of patients with preoperative lactic acid content≤2.5 mmol/L. Conclusion:For adult hydrocephalus patients without intracranial infection but only with abnormal CSF (glucose content<2.5 mmol/L or lactic acid content>2.5 mmol/L), ventriculoperitoneal shunt should only be performed after further improvement of CSF indexes to avoid increasing postoperative infection.