Risk factors for postoperative intracranial infection following craniotomy and development and application of a web-based dynamic nomogram prediction tool
QU Tingfeng
OU Jie Yan
LI Liangming
LIN Qichang
LIN Weibiao
Abstract：Objective To explore the independent risk factors for postoperative intracranial infection following craniotomy and to construct a nomogram prediction model for clinical guidance.Methods The clinical data of 419 patients who underwent craniotomy at Zhongshan City People's Hospita from May 2017 to April 2022 were retrospectively analyzed.Postoperative intracranial infection was diagnosed based on the 2021 Chinese Expert Consensus on Diagnosis and Treatment of Central Nervous System Infections in Neurosurgery.Multivariate logistic regression analysis was used to identify independent risk factors for postoperative intracranial infection,and a nomogram prediction model was constructed.A web-based dynamic nomogram was developed using the shinyapps.io software.Results Among the 419 patients,53 developed postoperative intra-cranial infection,with an incidence rate of 12.6%.Multivariate logistic regression analysis showed that prolonged surgery dura-tion,large intraoperative blood loss,postoperative cerebrospinal fluid leakage,≥2 surgical operations,and frequent cerebrospi-nal fluid sampling or drug administration via drainage tubes were independent risk factors for postoperative intracranial infection(P<0.05).Based on these five independent risk factors,a nomogram prediction model for postoperative intracranial infection was successfully established.ROC curve analysis indicated good discrimination of the model[area under the curve:0.826(95%CI 0.768～0.884)].The Hosmer-Lemeshow goodness-of-fit test showed that the predicted curve of the nomogram model largely overlapped with the ideal curve.Decision curve analysis demonstrated high clinical utility of the nomogram model.A dynamic nomogram was developed using R software and transformed into a web-based version via shinyapps.io,accessible at: Prolonged surgery duration,large intraoperative blood loss,postoperative ce-rebrospinal fluid leakage,≥2 surgical operations,and frequent cerebrospinal fluid sampling or drug administration via drainage tubes are independent risk factors for postoperative intracranial infection.The nomogram prediction model based on these risk factors exhibits good predictive performance.The developed web-based dynamic nomogram is user-friendly,provides accurate calculations,and is applicable in clinical practice.
Keywords：craniotomypostoperative intracranial infectionrisk factorsnomogramweb-based dynamic nomogram
Publication Date：2025-10-25
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：6( 607-612 )