Evaluating Intervention Strategies and Recovery Patterns in Intracranial Infections Using Matched Statistical Modeling

Abstract

Multiple surgical strategies are available for managing intracranial infections, with standard open procedures and image-guided minimally invasive techniques being the most commonly employed. However, it remains uncertain which approach yields better outcomes when patient baseline factors are comparable. This retrospective investigation evaluated clinical features, microbiological data, and treatment results over a 14-year span among adult individuals who underwent surgical intervention for this condition. A statistical balancing method was used to address variations in pre-treatment factors potentially influencing surgical decisions.

A total of 91 adult cases were included, with 53 undergoing traditional open surgery and 38 treated via stereotactic-guided aspiration. The most frequently observed symptom at presentation was localized neurological impairment, noted in 60 patients (65.9%). Favorable functional status, defined as a Glasgow Outcome Scale (GOS) score of 4 or 5, was achieved in 67 individuals (73.6%), while 7 (7.7%) did not survive.

Analyses indicated no statistically significant link between the type of surgical approach and treatment outcome (Odds Ratio [OR] 1.181; 95% Confidence Interval [CI] 0.349–3.995). Similarly, the interval from diagnosis to surgical intervention had no measurable effect (OR 0.998; 95% CI 0.981–1.015). Propensity-adjusted preference for open surgery was also not associated with improved recovery (OR 1.181; 95% CI 0.349–3.995). The only independent predictor of a less favorable outcome (GOS < 4) was a lower score on the Glasgow Coma Scale at admission (OR 0.787; CI 0.656–0.944). Overall, the findings suggest that surgical method selection does not significantly impact recovery, but initial neurological status plays a key prognostic role.