The risk factors and prediction model for postoperative pneumonia after craniotomy.

Background: Craniotomy is highly susceptible to postoperative pneumonia, which significantly impacts the outcomes of patients undergoing such procedures. Our study aims to examine the risk factors associated with postoperative pneumonia and establish a predictive model with a nomogram to assess this risk. Methods: We conducted a matched 1:1 case-control study involving 831 adult patients undergoing craniotomy at our hospital. Cases consisted of patients who developed postoperative pneumonia within 30 days after surgery, as defined by consensus criteria. Controls were randomly selected from a pool of eligible patients. Results: The overall incidence rate of postoperative pneumonia is 12.39% in a total of 831 surgeries, which associated with unfavorable outcomes. Gram-negative bacteria were found to be the most common causative agents and approximately 27.94% of cases attributed to multi-drug resistant strains. The logistic regression analysis revealed five independent risk factors, as follows: smoking history, surgical duration, postoperative albumin, unplanned re-operation, and deep vein catheterization. A risk prediction model was derived and a nomogram was constructed. The Hosmer-Lemeshow test yielded X Conclusions: Postoperative pneumonia patients after craniotomy exhibits distinct pathogen distribution and is strongly associated with unfavorable outcomes. The risk prediction model developed in this study demonstrates a good fitting degree and predictive performance. The constructed nomogram model is objective, specific, and easily applicable in clinical practice.