The relationship between colloid transfusion during surgical decompression hemicraniectomy period and post-operative pneumonia or long-term outcome after space-occupying cerebral infarction: A retrospective study.

BACKGROUND: The colloid transfusion during surgical decompressive hemicraniectomy (DHC) after space-occupying cerebral infarction induced by middle cerebral artery (MCA), is controversial. A multicenter retrospective study was conducted to determine whether or not an increased colloid transfusion during surgery is associated with lower incidence of post-operative pneumonia and better long-term outcomes after space-occupying cerebral infarction.

METHOD: Data from surgical DHC within 48 h to treat space-occupying cerebral infarction that took place between Nov. 30th 2013 and Nov. 30th 2016 were collected in a multicenter chart. Univariate analysis, spearman correlation, chi-square test, bivariate and multivariate logistic regression, were performed to account for the associations between colloid transfusion and post-operative pneumonia or long-term outcomes (indicated by Modified Rankin scores [MRS]).

RESULTS: Univariate analysis showed that surgical duration and MRS were significantly difference between the subjects older and younger than 60 years who underwent surgical DHC (P<0.05). In the entire population studied, increased National Institutes of Health stroke scale (NIHSS) was associated with higher incidence of post-operative pneumonia (OR =1.255, P=0.003) and increased MRS (OR =1.229, P=0.014). In the population aged greater than 60 years, it was revealed that increased colloid transfusion was associated with lower incidence of post-operative pneumonia (OR =0.761, P=0.030) or better outcomes indicated with lower MRS (OR =0.837, P=0.045).

CONCLUSION: Our retrospective study demonstrated that there is a robust association between increased peri-operative colloid transfusion and lower incidence of post-operative pneumonia and better outcomes among the patients older than 60 years after space-occupying cerebral infarction.