A retrospective observational study of risk factors for postoperative meningitis following resection of meningioma

Objective: This retrospective observational study aimed to explore the risk factors for postoperative meningitis following resection of meningioma. Methods: A total of 937 patients older than 18 years who underwent meningioma resection at the Department of Neurosurgery of three grade-A general hospitals in Sichuan Province between January 2021 and June 2024 were included. Basic patient information and perioperative variables were evaluated as risk factors for meningitis. Univariate and multivariate analyses were performed to identify the risk factors for postoperative meningitis. Results: Overall, 47 (5.0%) of the 937 patients were infected with postoperative meningitis. Univariate analysis revealed that albumin level (<3.5 mg/dL; p = 0.017), preoperative hospitalization (median: 4 days; interquartile range: 2-6 days; p = 0.034), tumor location (skull base; p < 0.001), surgery duration (>3 h; p < 0.001), and bleeding volume during operation (>= 400 mL; p < 0.001) were significantly associated with postoperative meningitis following resection of meningioma. The average postoperative hospital stay in the postoperative meningitis group was 14 days, whereas it was 6 days in the nonpostoperative meningitis group (p < 0.001). Furthermore, multivariate analysis showed that tumor location (skull base; p = 0.004; odds ratio = 2.914; 95% confidence interval: 1.395-6.091), surgery duration (>3 h; p = 0.006; odds ratio = 3.024; 95% confidence interval: 1.370-6.674), and bleeding volume during operation (p = 0.034; odds ratio = 2.057; 95% confidence interval: 1.056-4.006) were independent risk factors for postoperative meningitis following resection of meningioma. Conclusion: Tumor location (skull base), longer surgery duration (>3 h), and higher bleeding volume during operation (>= 400 mL) were independent risk factors for postoperative meningitis following resection of meningioma. Moreover, postoperative meningitis was associated with a prolonged hospital stay. These findings can help identify patients with meningioma in need of special intervention to prevent postoperative meningitis and can help surgeons preoperatively identify the risk of postoperative meningitis for meningioma.