Invasive procedures and risk of brain abscess: a nationwide, population-based case-control study

Abstract

Objectives

It is unknown whether invasive procedures are associated with brain abscess.

Methods

Nationwide, population-based, matched case–control study of patients with culture verified brain abscess in Denmark from 1989 to 2016. Exposure was invasive procedures 0–6 months before study inclusion.

Results

We identified 435 patients and 3909 controls. The level of comorbidity was higher among patients with brain abscess than among controls. A total of 48 cases (11%) had one or more invasive procedures 0–6 months before study inclusion (adjusted odds ratios (aOR) of 3.6 (95% confidence interval (CI): 2.5–5.1), a population attributable fractions of 8% (95% CI: 7–9)). In primary care, ear, nose and throat (ENT) procedures were associated with brain abscess (aOR of 4.0 (95% CI: 2.0–8.0)), but gastrointestinal endoscopies were not (aOR of 1.0 (95% CI: 0.3–3.2)). No bronchoscopies were performed in primary care. In the hospital-based setting, ENT procedures, bronchoscopies and gastrointestinal endoscopies were associated with an increased risk of brain abscess (aOR of 14.5 (95% CI: 4.8–43.8), 20.3 (95% CI: 3.8–110.1) and 3.4 (95% CI: 2.0–5.6), respectively).

Conclusions

The association between invasive procedures and brain abscess was more pronounced in the hospital-based setting than in primary care.

Keywords:

• Brain abscess
• CNS infection
• invasive procedures
• risk factors

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are stored in Statistics Denmark and according to Danish data protection cannot be shared.

Additional information

Funding

This work was supported by research grant to LHO from Copenhagen University Hospital, Rigshospitalet. The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.