To explore the independent influencing factors of hospital-acquired pneumonia (HAP) in Neurosurgical Intensive Care Unit (NICU) after emergency craniotomy for acute spontaneous cerebral hemotoma removal, as to provide important reference data for clinic.

The medical record data of 207 enrolled patients with emergency craniotomy for acute spontaneous cerebral hematoma removal in NICU of Sichuan Provincial People's Hospital from January 2016 to June 2021 were retrospectively analyzed. According to the patients with acute spontaneous intracerebral hemorrhage in NICU, whether they had hospital-acquired pneumonia after emergency craniotomy and hematoma removal, they were divided into infection group and non-infection group. Multiple Logistic regression analysis was used to screen for independent risk factors for HAP in NICU patients with spontaneous intracerebral hemorrhage after emergency craniotomy.

Of the patients enrolled in this study, 127 cases were in the infection group and 80 cases in the non-infection group. There were significant differences between patients in infection and non-infection groups in age, GCS score≤8 on admission, preoperative blood glucose, preoperative albumin, hypertension, operation duration, and postoperative mechanical ventilation. The factors with P<0.1 were included in the multivariate Logstic regression analysis, and the results showed that those with GCS score≤8 on admission, operation duration ≥240 min (4 h), postoperative mechanical ventilation, preoperative blood glucose≥10.0 mmol/L, and preoperative albumin<42.5 g/L were the independent risk factors for HAP in patients with spontaneous intracerebral hemorrhage undergoing emergency craniotomy and hematoma evacuation in NICU.

The independent risk factors for HAP in patients with spontaneous intracerebral hemorrhage undergoing emergency craniotomy and hematoma evacuation in NICU include admission GCS score ≤8, operation duration ≥4 h, postoperative mechanical ventilation, preoperative blood glucose ≥10.0 mmol/L, and preoperative albumin <42.5 g/L. Early screening and corresponding prevention and treatment measures can help reduce the incidence of postoperative HAP and improve long-term prognosis.