Deep brain stimulation-related infections: Analysis of rates, timing, and seasonality

Fran A. Hardaway, Ahmed Raslan, Kim Burchiel

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: Infection is one of the most common complications of deep brain stimulation (DBS). Long-term infection rates beyond the immediate postoperative period are rarely evaluated. Objective: To study short- and long-term DBS-related infection rates; to evaluate any potential seasonality associated with DBS-related infections. Methods: We retrospectively reviewed all DBS surgeries performed in a 5-yr period at 1 hospital by a single surgeon. Infection rates and clinical characteristics were analyzed. Postoperative "infections" were defined as occurring within 6 mo of implantation of DBS hardware, while "erosions" were defined as transcutaneous exposure of hardware at ≥6mo after implantation. Based on the date of surgery preceding an infection, rates of infection were calculated on a monthly and seasonal basis and compared using Chi square and logistic regression analyses. Results: A total of 443 patients underwent 592 operations; 311 patients underwent primary DBS placement with 632 electrodes. Primary DBS placement infection incidence was 2.6%. DBS procedure infection and infection rate by electrode were 2.9% and 3.2%, respectively. Infectious complications presented later than 6 mo postoperatively in 38% of infected patients Summer (July-September) infection rate was significantly higher than other seasons (P = .002). The odds ratio of an infection related to a surgery performed in August was found to be 4.15 compared to other months (P = .021). Conclusion: There is a persistent risk of DBS infection and erosion beyond the first year of DBS implantation. Start of the academic year was associated with increased infection rate at our institution.

Original languageEnglish (US)
Pages (from-to)540-547
Number of pages8
JournalClinical Neurosurgery
Volume83
Issue number3
DOIs
StatePublished - Jan 1 2018

Keywords

  • Deep brain stimulation (DBS)
  • Erosion
  • Infections
  • July effect

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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