Clinical differences and prognostic factors for unfavourable outcome in community-acquired versus health care-associated intracranial empyema and abscess

Clinical differences and prognostic factors for unfavourable outcome in community-acquired versus health care-associated intracranial empyema and abscess | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical differences and prognostic factors for unfavourable outcome in community-acquired versus health care-associated intracranial empyema and abscess Rubi Stephani Hellwege, Meltem Gönel, Martina Sebök, Johannes Sarnthein, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8357670/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Background Intracranial empyema and brain abscess are rare but severe central nervous system infections. Community-acquired (CA) cases typically arise from sinus, otogenic, dental, or haematogenous sources, whereas health care-associated (HCA) infections occur as postoperative complications following neurosurgical interventions. Comparative data between these entities remain limited. This study assessed clinical presentation, microbiology, intensive care requirements, and outcomes in CA versus HCA infections and identified predictors of unfavourable neurological outcome. Methods We conducted a retrospective single-centre study of adults treated for intracranial empyema or abscess at the University Hospital Zurich (2012–2023). Patients were categorised as CA or HCA. Demographic, clinical, radiological, microbiological, and ICU variables were analysed. The primary outcome was neurological function at discharge and 3–6 months using the Glasgow Outcome Scale–Extended (GOSE). Secondary outcomes included ICU admission, in-hospital mortality, and microbiology. Logistic regression identified predictors of unfavourable outcome. Results Eighty-four patients were included (37 CA, 47 HCA). CA patients were younger (52 vs 59 years; p = 0.047), presented with lower GCS (13.5 vs 14.7; p = 0.024), more frequently had new focal neurological deficits (78.4% vs 40.4%; p = 0.001), disturbances of consciousness (29.7% vs 10.6%; p = 0.048), and sepsis (43.2% vs 21.3%; p = 0.036). ICU admission (81.0% vs 31.9%; p < 0.001) and hospital stay (19 vs 12 days; p = 0.002) were higher in CA patients. Microbiology differed substantially: Staphylococcus aureus was more common in HCA infections (44.7% vs 8.1%; p < 0.001), whereas Streptococcus spp. predominated in CA infections (64.9% vs 4.3%; p < 0.001). Functional outcomes were comparable between groups at discharge (GOSE 7 vs 6; p = 0.144) and follow-up (7 vs 7; p = 0.377). Sepsis (p = 0.003) and low GCS at diagnosis (p = 0.006) predicted unfavourable outcome in univariable analysis; only SAPS II independently predicted mortality (OR 1.20 per point; 95% CI 1.05–1.37; p = 0.009). Conclusion CA infections presented with more severe neurological and systemic impairment but achieved similar long-term functional outcomes as HCA infections. Prognosis appears to depend primarily on initial disease severity rather than infection origin or comorbidity burden. Trial registration Not applicable (retrospective study) Brain abscess Community-acquired infection Glasgow Outcome Scale-Extended (GOSE) Health care-associated infection Intensive care Intracranial empyema Microbiology Neurological outcome Prognostic factors Sepsis Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Intracranial empyema and brain abscess are rare but life-threatening infections of the central nervous system (CNS) that require immediate neurosurgical and antimicrobial treatment [ 1 – 6 ]. Despite advances in neuroimaging, antimicrobial therapy, and intensive care, they remain associated with substantial morbidity and mortality, with reported case-fatality rates of 10–30% [ 1 – 7 ]. The pathogenesis differs between community-acquired infections (CA), typically arising from contiguous spread of local infection, and health care-associated infections, which develop as complications of surgical interventions [ 6 , 8 – 11 ]. These groups differ in their microbiological spectrum: streptococci and anaerobes usually predominate in CA cases, whereas Staphylococcus aureus and other hospital-acquired pathogens such as Gram-negative bacteria are more frequent in HCA patients [ 2 , 3 , 12 – 16 ]. This microbiological distinction is reflected in the current treatment recommendations of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), which advocate a third-generation cephalosporin combined with metronidazole for community-acquired infections, and meropenem or alternatively ceftazidime combined with vancomycin for post-neurological cases [ 4 ]. Recent studies employing advanced sequencing techniques rather than conventional culturing methods suggest the involvement of a broader range of pathogens within brain abscesses than previously suspected [ 17 – 20 ]. However, the clinical relevance of these findings remains to be determined. Clinical presentation is often non-specific and ranges from headache and fever to focal neurological deficits, seizures, or altered consciousness [ 5 , 8 , 9 ]. Prognosis is influenced by timeliness of diagnosis, extent of infection, and systemic complications such as sepsis [ 15 , 21 , 22 ]. Most available studies, however, describe heterogeneous cohorts without stratifying by infection origin [ 2 , 5 , 7 , 8 ]. CA infections usually affect younger, otherwise healthy patients, whereas HA cases occur in older patients with higher comorbidity burden and exposure to hospital pathogens [ 3 , 21 , 23 ]. These fundamental differences suggest potentially distinct clinical courses and prognostic determinants [ 24 ]. Nevertheless, only a few studies directly compare intensive care requirements, microbial profiles, and neurological outcomes between the two entities [ 3 , 10 , 24 ]. Evidence regarding prognostic factors is also inconsistent. Some studies emphasize surgical status and comorbidities as outcome drivers, while others identify severity of the initial presentation—such as low Glasgow Coma Scale (GCS) or presence of sepsis—as the main determinant [ 7 – 9 , 25 , 26 ]. This uncertainty complicates early risk stratification and treatment decisions in clinical practice [ 2 , 7 ]. In light of these knowledge gaps, the objective of this study was to systematically investigate differences in clinical presentation, microbiology, intensive care management, and outcomes between patients with CA and HCA intracranial empyema or abscess. Methods Study Design and Setting. This retrospective, single-centre cohort study was conducted at the Institute for Intensive Care Medicine at the University Hospital Zurich, a tertiary care academic centre in Switzerland. Patient data were collected from January 2012 to January 2023. 2) Study Population. The study population comprised adult patients (≥ 18 years) with a diagnosis of intracranial empyema or abscess. Empyema and abscess were defined according to clinical and radiological criteria, following the Infectious Diseases Society of America (IDSA) recommendations [ 12 ]. Empyema was defined as a purulent collection within the subdural or epidural space, whereas abscess was defined as a localized, encapsulated infection within the brain parenchyma. Radiological findings were assessed using computed tomography (CT) and/or magnetic resonance imaging (MRI) and interpreted according to the recommendations of the Infectious Diseases Society [ 2 , 12 ]. The diagnosis was confirmed through radiological imaging and/or intraoperative neurosurgical findings. Patients were excluded from the study if they were under the age of 18, had no confirmed diagnosis, or had refused general consent. Patients were stratified into two groups: Community-acquired infections (CA) , defined as intracranial empyema or brain abscess not related to a previous neurosurgical intervention and typically arising from contiguous spread of sinusitis, otitis, or dental infections, or by haematogenous dissemination from distant sources such as endocarditis. Health care-associated infections (HCA) , defined as intracranial empyema or brain abscess occurring after craniotomy or other neurosurgical procedures. To avoid immortal time bias, the observation period for all patients was defined as starting on the date of confirmed diagnosis of intracranial empyema or abscess. Observation time therefore began uniformly for both CA and HCA cases, independent of the timing of the initial hospital admission or neurosurgical procedure. 3) Data Collection A comprehensive data extraction was conducted from the Neurosurgery Registry at the University Hospital Zurich [ 27 ], encompassing demographic, clinical, surgical, laboratory, radiological, microbiological, and outcome data. The data presented herein were obtained from electronic medical records and institutional databases (KISIM-TM, Cistec®, Zurich, Switzerland). The following variables were analysed: baseline characteristics , including age, sex, Charlson Comorbidity Index (CCI) [ 28 ], American Society of Anesthesiologists (ASA) classification, immune status, preexisting infectious disease, neurological symptoms at admission; data on infection; including type and localization of infection, microbiological culture results, imaging finding s; characteristics of the intensive care unit stay , and neurological functional outcomes at hospital discharge and at 3 to 6 months, as assessed with the Glasgow Outcome Scale-Extended (GOSE) [ 29 ]. The CCI is a validated scoring system that quantifies comorbidity burden by assigning weighted points to a range of chronic diseases such as cardiovascular, pulmonary, renal, hepatic, and oncological conditions. It provides an overall estimate of the patient’s baseline health status and risk of mortality [ 28 ]. Immune status referred to the presence of human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), use of immunosuppressive medication (e.g. corticosteroids, calcineurin inhibitors, antimetabolites, or biologics), and underlying haematological or oncological disease. Patients with documented AIDS or with any of the other aforementioned conditions were designated as immunocompromised [ 30 – 33 ]. The CCI was utilised to ascertain additional comorbidities with the potential to affect immune competence, including diabetes and chronic organ disease. Clinical presentation was evaluated by neurological symptoms and level of consciousness at admission using the Glasgow Coma Scale (GCS), a widely used and previously published neurological assessment tool [ 34 ], as well as serum inflammation markers. Symptom onset was defined as the earliest documented neurological or systemic symptom attributable to intracranial empyema or abscess. The onset date was extracted retrospectively from clinical documentation, including emergency department notes, neurology and neurosurgery assessments, as well as patient or relative history recorded by the treating physicians. Symptoms used to determine symptom onset comprised neurological and systemic signs typically associated with intracranial empyema or abscess, as extracted from retrospective clinical documentation. Microbiological results were collected from intraoperative specimens, cerebrospinal fluid, or blood cultures. Preexisting infectious disease was defined as a history of wound or soft tissue infection or antibiotic treatment, within six weeks prior to admission. This pragmatic definition was based on the categories of soft tissue infections described in the IDSA guidelines [ 12 ]. ICU-related variables included presence of sepsis or septic shock, need for mechanical ventilation, renal replacement therapy, vasopressors, and ICU length of stay. Sepsis and septic shock were defined in accordance with the international consensus guidelines (Sepsis-3) endorsed by the European Society of Intensive Care Medicine (ESICM) and the Society of Critical Care Medicine (SCCM) [ 22 , 35 ]. Empirical antibiotic therapy was started with ceftriaxone and metronidazole -in case of CA infections- or vancomycin and ceftazidime or meropenem- in case of HCA infections- according to our internal guidelines, and subsequently tailored to microbiological results. 4) Outcomes The primary outcome was functional neurological status at hospital discharge and at 3–6 months, measured by the GOSE [ 29 ]. GOSE was assessed during outpatient follow up or during neurorehabilitation based on the follow up visits or discharge letters from the rehabilitation hospital. Neurological outcomes were dichotomized as favourable (GOSE > 5) and unfavourable outcome (GOSE ≤ 4) [ 36 – 38 ]. Secondary outcomes included in-hospital mortality, ICU admission rate, length of stay, need for mechanical ventilation and vasopressors, and microbiological differences between groups. 5) Statistical Analysis Continuous variables were summarised as median and interquartile range (IQR) and compared using the Mann–Whitney U test. Categorical variables were presented as counts and percentages and compared with the χ² test or Fisher’s exact test, as appropriate. Univariable logistic regression was performed to explore associations between clinical variables (age, sex, CCI, primary vs postoperative infection, GCS on admission, and sepsis) and unfavourable outcome. Variables with clinical relevance and statistical significance in univariable analyses were further examined in multivariable models. In addition, a separate multivariable logistic regression model was constructed to identify predictors of in-hospital mortality. All analyses were conducted using Python (version 3.11) with the packages pandas , statsmodels , and scikit-learn . Graphical output was generated using matplotlib and Prism 10.2.0 (GraphPad, La Jolla, CA, USA). Statistical significance was set at p < 0.05. 6) Data protection and ethics The study was conducted in accordance with the Declaration of Helsinki and approved by the Cantonal Ethics Committee Zurich (Kantonale Ethikkommission Zürich, KEK Zurich), Switzerland (BASEC-No. PB-2017-00093). Owing to the retrospective design of the study, the requirement for informed consent was waived by the ethics committee. Prior to analysis, all data were pseudonymised, and strict confidentiality was maintained throughout the study in compliance with institutional and national data protection regulations. Results A total of 131 patients diagnosed with intracranial empyema or abscess were initially screened from the Neurosurgery Registry at the University Hospital of Zurich [27]. The excluded patients are presented in Fig. 1. Overall, 84 patients had a confirmed diagnosis. These were categorised as CA (n= 37) and HCA (n= 47) as shown in Fig. 1. Baseline characteristics are presented in Table 1. HCA patients were significantly older than those with CA infections (median 59 [IQR 48–70] vs 52 [33–63] years, p = 0.047). The time from symptom onset to diagnosis was longer for CA infections (median 4.0 [1.0–8.0] vs. 1.0 [0.0–5.0] days), although this trend was not significant (p = 0.067). The CCI was significantly higher in patients with HCA empyema/abscess than in those with CA (median 3.0 [IQR 1.0–7.0] vs 2.0 [IQR 1.0–3.0], p = 0.015) (Table 1). CA patients presented more frequently with neurological symptoms, such as disturbed consciousness (29.7% vs. 10.6%, p = 0.048) and other CNS-related symptoms (64.9% vs. 29.8%, p = 0.002) (Table 2). The mean GCS at diagnosis was lower in the CA empyema/abscess group compared to the HCA cases (13.5 ±3.0 vs. 14.7 ±0.7, p = 0.024). There were significant differences in neurological symptoms at presentation between the groups. New-onset focal neurological deficits (FND) were markedly more frequent in patients with CA empyema/abscess than in HCA cases (78.4% vs. 40.4%, p = 0.001), particularly hemiparesis (40.5% vs. 14.9%, p = 0.012) and neglect (18.9% vs. 4.3%, p = 0.039) (Table 2). CA empyema/abscesses were associated with paranasal sinusitis (18.9%), pathological cerebrospinal fluid (CSF) indicative of CNS infections (29.7%), dental/jawbone infections (10.8%), otitis/mastoiditis (10.8%), and endocarditis (8.1%) (Fig. 2). HCA empyema or abscess occurred mostly following primary tumour resection (n = 19, 40.4%), metastasis resection (n=10, 21.2%), and trauma (n=9, 19.1%). This was followed by vascular pathology (n=7, 15.5%) and epilepsy (n=2, 4.2%). Almost all procedures were supratentorial (n=46, 97.8%), with the majority being elective (n=34, 72.3%) rather than urgent (n=13, 27.7%). (Fig. 3). Abscesses were more frequent in CA cases (86.5% vs. 44.7%, p < 0.001), whereas empyema was more frequent in HCA cases (66.0% vs. 24.3%, p < 0.001), including cases of multiple empyema localisations (19.1% vs. 2.7%, p = 0.037). Regarding infection characteristics, sepsis was significantly more frequent in patients with CA infections (43.2% vs. 21.3%, p = 0.036). Among the total study population, 22 patients underwent lumbar puncture with CSF analysis at admission. All showed evidence of inflammation, defined by pathological CSF findings (pleocytosis, elevated protein, low glucose, and/or high lactate). Positive CSF cultures were more frequently observed in the CA group, although this difference did not reach statistical significance (6.4% vs. 8.1%, p = 1.000). Osteomyelitis was significantly more frequently detected in HCA patients (36.2% vs. 2.7%, p < 0.001) (Table 3a). Among patients with positive cultures, the median number of pathogens per infection was higher in the CA than in the HCA infections (2 [IQR 1–3] vs 1 [IQR 1–2]), although this difference did not reach statistical significance (p = 0.19). Polymicrobial infections occurred in 56.8% of CA cases and 45.7% of HCA cases (p = 0.31) as shown in Table 3b and in Fig. 4. The microbiological spectrum differed markedly between the two groups. CA infections were dominated by Streptococcus anginosus (n = 21, 56.8%), Aggregatibacter aphrophilus (n = 6, 16.2%), and Parvimonas micra (n = 6, 16.2%), followed by Staphylococcus epidermidis (n = 6, 16.2%) and mixed anaerobic flora (n = 4, 10.8%). Less frequent isolates included Actinomyces spp., Prevotella intermedia , Streptococcus pneumoniae , and Fusobacterium necrophorum . Aspergillus spp. were detected in three patients, all within the CA group (3.6% of the total cohort); each was immunocompromised due to underlying oncological disease or immunosuppressive therapy (Table 3b). In contrast, HCA infections were primarily caused by Staphylococcus aureus (n = 19, 41.3%), Cutibacterium acnes (n = 15, 32.6%), and Staphylococcus epidermidis (n = 10, 21.7%), followed by Proteus mirabilis (n = 7, 15.2%) and Klebsiella aerogenes (n = 6, 13.0%). Other occasionally isolated pathogens included Enterobacter cloacae , Citrobacter koseri , Pseudomonas aeruginosa , Dermabacter hominis , Escherichia coli , and Nocardia beijingensis . One patient in this group had no pathogen identified. In the HCA infection group, a total of 10 isolates with chromosomally encoded AmpC β-lactamases were detected ( Klebsiella aerogenes = 6, Enterobacter cloacae complex = 2, Serratia marcescens = 1, Morganella morganii = 1). This corresponds to 9 of 47 cases (19%), which were not optimally covered by the locally recommended initial therapy regimen of ceftazidime and vancomycin. 16S rRNA gene PCR or 18S rRNA gene PCR was performed only in cases with no growth in conventional culturing. Anaerobes may be underdiagnosed based on conventional culturing techniques used in routine microbiological diagnostics. None of the Staphylococcus aureus isolates from either CA or HCA infections were methicillin-resistant (MRSA). Susceptibility profiles of all pathogens isolated via conventional culturing did not differ from those of the respective wild-type populations. Overall, CA infections were characterized by oral commensals and anaerobes, whereas HCA infections were predominantly staphylococcal, Cutibacterium , and Gram-negative organisms typical of postoperative or nosocomial flora. The detailed distribution of pathogens is provided in Table 3b and in Supplementary Tables S1-2, and the administered antimicrobial regimens in Supplementary Table S3. The total duration of antibiotic therapy, including empirical and targeted treatment phases, was comparable between the groups. Admission to the ICU was significantly more frequent in patients with CA intracranial empyema/abscess than in HCA cases (81.0% vs. 31.9%, p < 0.001). The discharge destination differed, with HCA patients being more frequently discharged home (46.8% vs. 24.3%, p = 0.042), whereas patients with CA infections to a rehabilitation clinic (56.7% vs. 34.0%, p = 0.048). In terms of the clinical course, patients with CA infections had a significantly longer hospital stay than HCA cases (median 19 days [(IQR) 11–26] versus 12 days [IQR 8–16], p = 0.002). Neurological outcomes showed no significant differences at either discharge (median GOSE 7 vs. 6, p = 0.144) or at the 3–6 month follow-up (median GOSE 7 in both groups, p = 0.377). Patients who died before the scheduled neurosurgical follow-up (n=7) were excluded from the GOSE analysis, as they were already classified as in-hospital deaths. In the univariable analysis, patients with unfavourable outcome at discharge had both a lower GCS at diagnosis and developed sepsis more frequently than patients with favourable outcome (Supplementary Table S4, Fig. S1). In the multivariable logistic regression analysis only the SAPS II score was found to be a predictor for mortality (B = 0.18, OR = 1.20, 95% CI [1.05, 1.37], p = 0.009). After adjusting for severity scores, no significant association was found for age, sex, or other clinical features such as seizures, fever or CNS symptoms (Supplementary Table S5, Fig S2). Discussion In this single-centre retrospective study, we investigated differences between patients with CA and HCA intracranial empyema or abscess. As main findings, we reported that CA cases presented with more severe neurological impairment —lower GCS, higher rates of focal neurological deficits and disturbed consciousness— and were more often septic at admission. Consequently, they required more frequent and prolonged ICU treatment. Additionally, microbiological patterns also differed between the two entities: streptococci and oral anaerobes predominated in CA infections, whereas Staphylococcus aureus and Gram-positive rods were characteristic of HCA cases. Polymicrobial growth was common in both entities (58% vs. 45%, p = 0.31), suggesting that intracranial empyema frequently arises from mixed bacterial sources rather than single pathogens. The observed differences in disease severity at presentation may also, at least in part, reflect a diagnostic or detection bias. Patients with HCA infections are routinely monitored in the hospital, which may facilitate earlier recognition and management of infection. In contrast, patients with CA infections may present later, once neurological symptoms or systemic infection become evident. Although the time from symptom onset to diagnosis did not reach statistical significance in our cohort, a trend towards delayed diagnosis in CA cases could contribute to their more severe clinical presentation and higher rates of ICU admission. Despite these differences, short- and long-term functional outcomes were comparable between groups, although one might expect that the underlying condition that led to surgery could also negatively affect outcome. This suggests that early intensive management can mitigate the adverse impact of severe initial presentation. By contrast, postoperative patients had a higher comorbidity burden and showed a non-significant trend toward higher in-hospital mortality. This finding underlines that comorbidities and baseline health status remain important, even when initial neurological status is preserved. Our results highlight two key prognostic factors: initial neurological status and systemic infection severity (sepsis). Both were strongly associated with unfavourable outcomes, while demographic characteristics, comorbidities, and surgical status were less predictive. This is consistent with prior reports that stress the dominant role of disease severity at presentation over baseline characteristics in determining prognosis [ 21 – 23 , 25 , 26 ]. This aligns with previous studies on intracranial infections, which consistently emphasize the prognostic importance of disease severity at admission rather than baseline demographics or comorbidity burden [ 2 , 6 – 8 , 25 , 26 ]. However, in the multivariable analysis only the SAPS II score remained as a predictor for in-hospital mortality probably due to the relatively small sample size of our population. The finding that patients with HCA infections had a higher comorbidity burden highlights the importance of optimising patients before surgery and implementing preventive strategies during the perioperative period. A careful preparation of patients before elective neurosurgical procedures may help to reduce the risk of postoperative empyema or abscess. Therefore, optimising modifiable comorbidities, such as for example achieving good glycaemic control in diabetic patients should be integrated into surgical planning and perioperative care. Given the heterogeneous presentation and multifactorial pathogenesis of intracranial empyema and abscess, future research should aim to develop predictive models for postoperative infection risk following neurosurgical procedures [ 39 – 41 ]. Such models could integrate perioperative clinical characteristics — including comorbidity burden, surgical type, and microbiological risk factors— to identify patients at highest risk of postoperative infection. The utilisation of prospective multicentre datasets and machine-learning approaches holds potential in refining prediction scores and guiding targeted preventive strategies within the domain of neurosurgical practice [ 42 , 43 ]. The main strength of this study lies in the analysis of a dataset of detailed information on patients with both CA and HCA brain empyema and abscesses, including clinical presentation, symptoms, microbiological parameters, ICU-treatment, and outcomes. This comprehensive approach allows for direct comparisons between the two entities. The principal limitations are the retrospective nature of the analysis and that the data are derived from a single centre, which restricts the generalizability of the findings. Additionally, we were unable to perform a dedicated sub-analysis comparing empyema and abscess within each group (CA vs HCA) because of small subgroup sizes and an increased risk for both type II error and type I error, given the retrospective and exploratory study design. Finally, due to the relatively small sample size, it was not possible to perform a propensity-matched analysis in order to control for baseline differences between the groups. Consequently, the possibility of residual confounding and selection bias cannot be excluded. In summary, our findings suggest that CA and HCA intracranial empyema represent clinically distinct entities with different presentations and microbiological patterns. Nevertheless, their medium-term neurological outcomes may converge if early recognition, timely neurosurgical source control, and comprehensive intensive care support are ensured. Conclusion CA intracranial empyema and brain abscess are associated with more severe neurological and systemic manifestations than HCA empyema or abscess and necessitate more intensive ICU support. Nevertheless, long-term functional outcomes appear comparable, provided that timely neurosurgical and comprehensive intensive care management are initiated. Our findings underscore that initial neurological status and the presence of sepsis represent the key prognostic determinants, whereas demographic factors, comorbidity burden, and surgical status seem to play a less decisive role. Distinct microbiological profiles underline the need for tailored empirical therapy and reinforce the importance of early culture-guided antimicrobial adjustment. Abbreviations ASA American Society of Anaesthesiologists classification CA Community–acquired CCI Charlson Comorbidity Index CHD Coronary heart disease CI Confidence interval CNS Central nervous system COPD Chronic obstructive pulmonary disease CSF Cerebrospinal fluid CT Computed tomography CVA Cerebrovascular accident EEG Electroencephalogram ESCMID European Society of Clinical Microbiology and Infectious Diseases FND Focal neurological deficit GC General consent GCS Glasgow Coma Scale GOSE Glasgow Outcome Scale–Extended HCA Health care–associated HIV Human immunodeficiency virus ICU Intensive care unit IQR Interquartile range KISIM Klinisches Informationssystem (institutional electronic medical record) LOS Length of stay MRI Magnetic resonance imaging MRSA Methicillin–resistant Staphylococcus aureus OR Odds ratio PCR Polymerase chain reaction PVD Peripheral vascular disease SAPS II Simplified Acute Physiology Score II SD Standard deviation SOFA Sequential Organ Failure Assessment score TIA Transient ischaemic attack Declarations Competing Interests The authors declare that they have no competing interests Ethics approval and consent to participate The study was approved by the Cantonal Ethics Committee Zurich (Kantonale Ethikkommission Zürich, KEK Zurich), Switzerland (BASEC-No. PB-2017-00093). Owing to the retrospective design of the study and the use of pseudonymised routinely collected clinical data, the requirement for informed consent was waived by the ethics committee. The study was conducted in accordance with the principles of the Declaration of Helsinki. Consent for publication Not applicable Funding This research received no external funding. Author Contribution R.S.H. and G.B. conceptualized the study.R.S.H. and G.B. developed the methodology.R.S.H. performed the formal analysis.R.S.H., M.G., M.S., J.S., S.D.B., and D.W. contributed to the investigation.R.S.H., M.G., and D.W. curated the data.R.S.H. generated and prepared all figures, and D.W. generated Fig. 4.R.S.H. prepared all tables.R.S.H. drafted the original manuscript.All authors contributed to the review and editing of the manuscript.G.B. supervised the study.All authors read and approved the final manuscript. Acknowledgement We would like to express our gratitude to the staff of the Department of Neurosurgery and the Institute of Intensive Care Medicine at the University Hospital Zurich for their assistance with data retrieval and documentation. We would also like to express our gratitude to the members of the Neurosurgery Registry team for granting us access to the dataset used in this study. Data Availability The datasets generated and analysed during the current study are available from the corresponding author on reasonable request. References Moorthy RK, Rajshekhar V. Management of brain abscess: An overview. NeuroSurg Focus. 2008;24(6):E3. https://doi.org/10.3171/FOC/2008/24/6/E3 . Brouwer MC, Tunkel AR, McKhann GM, van de Beek D. Brain Abscess. N Engl J Med. 2014;371(5):447–56. https://doi.org/10.1056/NEJMra1301635 . Brouwer MC, Van De Beek D. Epidemiology, diagnosis, and treatment of brain abscesses. Current Opinion in Infectious Diseases. Volume 30. 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Machine Learning and Neurosurgical Outcome Prediction: A Systematic Review. World Neurosurgery. Volume 109. Elsevier Inc.; 2018. pp. 476–86. https://doi.org/10.1016/j.wneu.2017.09.149 . .e1. Senders JT, Zaki MM, Karhade AV, Chang B, Gormley WB, Broekman ML, et al. An introduction and overview of machine learning in neurosurgical care. Acta Neurochirurgica. Volume 160. Springer-Verlag Wien; 2018. pp. 29–38. https://doi.org/10.1007/s00701-017-3385-8 . Tables Table 1. Patient characteristics in community-acquired versus health care-associated intracranial empyema/abscess. Intracranial empyema/abscess (n=84) HCA (n=47) CA (n=37) Median (IQR) Mean (SD) N (%) Median (IQR) Mean (SD) N (%) p-value Age 59 (48-70) 57.3 (±15.6) 52 (33-63) 49.5 (±18.3) 0.047 Female 19 (40.4) 14 (37.8) 0.987 SAPS II score 18 (15-25.5) 19.5 (±7.7) 16 (15-29) 22.3 (±14.6) 0.874 SOFA score 0.0 (0.0-1.0) 0.8 (±1.1) 1.0 (0.0-3.0) 1.9 (±2.7) 0.063 ASA classification I 1 (2.1) 4 (10.8) 0.008 II 17 (36.2) 16 (43.2) 0.008 III 24 (51.1) 7 (18.9) 0.008 IV 5 (10.6) 10 (27) 0.008 Total CCI 3.0 (1.0-7.0) 3.8 (±3.0) 2.0 (1.0-3.0) 2.1 (±2.1) 0.015 History of MI or CHD 1 (2.1) 2 (5.4) 0.580 History of CHF 1 (2.1) 6 (16.2) 0.040 History of PVD 1 (2.1) 0 (0) 1.000 CVA or TIA 6 (12.8) 0 (0) 0.032 History of dementia 0 (0) 0 (0) 1.000 COPD 1 (2.1) 2 (5.4) 0.580 Connective tissue disease 0 (0) 1 (2.7) 0.440 Peptic ulcer disease 1 (2.1) 1 (2.7) 1.000 Chronic liver disease 2 (4.3) 2 (5.4) 1.000 Diabetes mellitus 3 (6.4) 4 (10.8) 0.694 Diabetes mellitus end-organ damage 0 (0) 2 (5.4) 0.191 Hemiplegia 4 (8.5) 1 (2.7) 0.378 Chronic kidney disease 1 (2.1) 3 (8.1) 0.316 Solid tumour 18 (38.3) 1 (2.7) <0.001 Metastatic solid tumour 10 (21.3) 0 (0) 0.002 Leukaemia 0 (0) 1 (2.7) 0.440 Lymphoma 1 (2.1) 1 (2.7) 1.000 AIDS 1 (2.1) 1 (2.7) 1.000 HIV infection 1 (2.1) 2 (5.4) 0.580 Alcohol abuse 1 (2.1) 3 (8.1) 0.316 Intravenous drug abuse 0 (0) 4 (10.8) 0.034 Chronic hepatitis C 1 (2.1) 2 (5.4) 0.580 Chronic hepatitis B 0 (0) 2 (5.4) 0.191 Immunosuppression 2 (4.3) 5 (13.5) 0.232 Symptoms to diagnosis (days) 1.0 (0.0-5.0) 4.9 (±10.3) 4.0 (1.0-8.0) 6.8 (±9.6) 0.067 Community-acquired (CA) infections were defined as intracranial empyema or abscess arising from contiguous or haematogenous spread in the absence of prior neurosurgical procedures. Health care-associated (HCA) infections were defined as postoperative intracranial empyema or abscess following neurosurgical intervention. Data are presented as number (percentage), mean ± standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher’s exact test for categorical variables and Mann–Whitney U test for continuous variables, according to data distribution. Abbreviations: ASA, American Society of Anaesthesiologists classification; SAPS II, Simplified Acute Physiology Score II; SOFA, Sequential Organ Failure Assessment score; CCI, Charlson Comorbidity Index; MI, myocardial infarction; CHD, coronary heart disease; PVD, peripheral vascular disease; CVA, cerebrovascular accident; TIA, transient ischaemic attack; COPD, chronic obstructive pulmonary disease; HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome. Table 2. Clinical presentation, neurological characteristics, and type of infection at admission. Intracranial empyema/abscess (n=84) HCA (n=47) CA (n=37) N (%) Mean (SD) Median (IQR) N (%) Mean (SD) Median (IQR) p-value Clinical characteristics Fever ≥ 38.2°C 13 (27.7) 10 (27.0) 1.000 GCS on day of diagnosis 14.7 (±0.74) 15 (15-15) 13.5 (±2.99) 15 (14-15) 0.024 Headache 21 (44.7) 16 (43.2) 1.000 Emesis 2 (4.3) 4 (10.8) 0.398 Malaise 4 (8.5) 5 (13.5) 0.498 Disturbance of consciousness 5 (10.6) 11 (29.7) 0.048 CNS symptoms and signs 14 (29.8) 24 (64.9) 0.002 Anisocoria 1 (2.1) 3 (8.1) 0.316 Meningism 2 (4.3) 6 (16.2) 0.130 FND new onset 19 (40.4) 29 (78.4) 0.001 Hemiparesis 7 (14.9) 15 (40.5) 0.012 Hypo- hyperesthesia 7 (14.9) 8 (21.6) 0.568 Aphasia 4 (8.5) 7 (18.9) 0.201 Visual field defects 2 (4.3) 4 (10.8) 0.398 Coordination disturbance 6 (12.8) 4 (10.8) 1.000 Cranial nerve dysfunction 3 (6.4) 3 (8.1) 1.000 Neglect 2 (4.3) 7 (18.9) 0.039 Dysarthria 1 (2.1) 5 (13.5) 0.083 Seizures 8 (17) 13 (35.1) 0.077 EEG on admission 3 (6.4) 7 (18.9) 0.098 ICP monitoring 3 (6.4) 6 (16.2) 0.173 Type of infection Abscess 21 (44.7) 32 (86.5) <0.001 Empyema 31 (66) 9 (24.3) <0.001 Abscess + empyema 5 (10.6) 4 (10.8) 1.000 Clinical presentation, neurological characteristics, and infection type at admission in community-acquired (CA) versus health care-associated (HCA) intracranial empyema or abscess. Data are presented as number (percentage), mean ± standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher’s exact test for categorical variables and Mann–Whitney U test for continuous variables, according to data distribution. CNS symptoms include focal neurological deficits, meningism, seizures, and cranial nerve dysfunction. Abbreviations: GCS, Glasgow Coma Scale; CNS, central nervous system; CSF, cerebrospinal fluid; FND, focal neurological deficit; EEG, electroencephalogram; ICP, intracranial pressure. Table 3. Infectious and microbiological characteristics of community-acquired versus health care–associated intracranial empyema/abscess. (a) Clinical infectious features Intracranial empyema/abscess (n=84) HCA (n=47) CA (n=37) N (%) N (%) p-value Sepsis 10 (21.3) 16 (43.2) 0.036 Septic shock 1 (2.1) 3 (8.1) 0.316 Positive blood cultures 4 (8.5) 8 (21.6) 0.119 Positive CSF cultures 3 (6.4) 3 (8.1) 1.000 Positive wound/abscess culture 47 (100) 35 (94.6) 0.191 Osteomyelitis 17 (36.2) 1 (2.7) < 0.001 (b) Microbiological profiles of culture-positive cases Positive cultures of empyema/abscess (n=83) HCA (n=46) CA (n=37) N (%) N (%) p- value Staphylococcus aureus 19 (41.3) 0 (0) <0.001 Cutibacterium acnes 15 (32.6) 0 (0) <0.001 Staphylococcus epidermidis 10 (21.7) 6 (16.2) 0.09 Streptococcus anginosus 0 (0) 21 (56.8) <0.001 Aggregatibacter aphrophilus 0 (0) 6 (16.2) 0.006 Parvimonas micra 0 (0) 6 (16.2) 0.006 Proteus mirabilis 7 (15.2) 0 (0) 0.015 Klebsiella aerogenes 6 (13) 0 (0) 0.031 Mixed anaerobic flora 0 (0) 4 (10.8) 0.036 Actinomyces spp. 0 (0) 3 (8.1) 0.085 Streptococcus pneumoniae 0 (0) 3 (8.1) 0.085 Aspergillus spp. 0 (0) 3 (8.1) 0.082 Other Gram-negative rods (incl. AmpC-producing species) 5 (10.9) 0 (0) 0.074 Monomicrobial infections 25 (54.3) 16 (43.2) 0.31 Polymicrobial infections 21 (45.7) 21 (56.8) 0.31 Median number of pathogens (IQR) 1 (1-2) 2 (1-3) 0.19 (a) Clinical infectious features including sepsis, septic shock, culture positivity from blood, cerebrospinal fluid (CSF), and wound or abscess samples, as well as the presence of osteomyelitis. (b) Microbiological profiles of culture-positive empyema or abscess cases. One health care-associated (HCA) infection showed no microbial growth and was therefore excluded from the microbiological analysis (HCA n = 46; community-acquired [CA] n = 37). Data are presented as number (percentage), mean ± standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher’s exact test for categorical variables and the Mann–Whitney U test for continuous variables, according to data distribution. Additional Declarations No competing interests reported. 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09:25:16","extension":"pdf","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":107566,"visible":true,"origin":"","legend":"","description":"","filename":"Fig2Sourcesofinfection.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/2a4b1cdf91f0cb401c4363de.pdf"},{"id":100126592,"identity":"d3e8defc-39aa-48f2-9009-0f879be6a4be","added_by":"auto","created_at":"2026-01-13 09:25:16","extension":"pdf","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":189383,"visible":true,"origin":"","legend":"","description":"","filename":"Fig3Surgicalcharacteristics.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/7137197e63ed7f54b8a7be33.pdf"},{"id":100126590,"identity":"720dbd1e-9bf6-4961-ba83-be4baa87cb0d","added_by":"auto","created_at":"2026-01-13 09:25:15","extension":"pdf","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":203586,"visible":true,"origin":"","legend":"","description":"","filename":"Fig4Microbiologicalcharacteristics.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/4e0b7e630d0d24a43b43ba40.pdf"},{"id":100126615,"identity":"7059f737-3470-4ad1-ad65-466acbc427df","added_by":"auto","created_at":"2026-01-13 09:25:22","extension":"xml","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":213238,"visible":true,"origin":"","legend":"","description":"","filename":"2cee6b758d934cf69a3f88e4759d92071structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/cf05cea6c0447c4903300657.xml"},{"id":100366055,"identity":"c5eacb48-fe6f-44ab-af01-cc4106277224","added_by":"auto","created_at":"2026-01-16 07:55:54","extension":"html","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":238326,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/980b7c414f2f9526c0380721.html"},{"id":100126625,"identity":"86fcd5ef-229c-4a34-b4c4-3fe279fb756b","added_by":"auto","created_at":"2026-01-13 09:25:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1423143,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of patient selection. A total of 131 patients were screened for intracranial empyema or abscess. After exclusions due to missing general consent (GC) or unconfirmed diagnosis, 84 patients were included and classified as community-acquired (CA) or health care-associated (HCA) infections.\u003c/p\u003e","description":"","filename":"Fig1Flowchartofpatientselection1.png","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/72babcad52561ef5c73ef6bd.png"},{"id":100126620,"identity":"2be118b8-ee59-4411-8696-8ce34e6de153","added_by":"auto","created_at":"2026-01-13 09:25:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":580388,"visible":true,"origin":"","legend":"\u003cp\u003eSources of infection in patients with community-acquired intracranial empyema/abscess. Abbreviations: CNS, central nervous system; CSF, cerebrospinal fluid.\u003c/p\u003e","description":"","filename":"Fig1Flowchartofpatientselection2.png","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/ec3138bddd8acef6a9006686.png"},{"id":100126613,"identity":"4f75853f-ecbb-4359-91d9-cc819e7449c8","added_by":"auto","created_at":"2026-01-13 09:25:21","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":728862,"visible":true,"origin":"","legend":"\u003cp\u003eSurgical characteristics, including underlying indications and procedural urgency, in patients with health care-associated intracranial empyema/abscess.\u003c/p\u003e","description":"","filename":"Fig1Flowchartofpatientselection3.png","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/832a3865c52fdb965f19c93a.png"},{"id":100366969,"identity":"99d5f9b3-b46a-4bfa-ae15-acfa0ea8e051","added_by":"auto","created_at":"2026-01-16 07:56:42","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":958576,"visible":true,"origin":"","legend":"\u003cp\u003eMicrobiological characteristics of culture-positive intracranial empyema/abscess in health care-associated (HCA) and community-acquired (CA) infections. The upper panels show the proportion of monomicrobial versus polymicrobial infections in HCA (n = 46) and CA (n = 37) cases (p = 0.31). The lower panels display the distribution of pathogen categories identified in 76 isolates per group.\u003c/p\u003e","description":"","filename":"Fig1Flowchartofpatientselection4.png","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/31ca7b32f002da4000e3a715.png"},{"id":100382248,"identity":"cdb66b2b-e75e-487b-8258-bd0326fec435","added_by":"auto","created_at":"2026-01-16 10:41:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":5067913,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/d917f9e2-d721-4142-8306-d56de09d064b.pdf"},{"id":100126647,"identity":"fa48175b-70b5-40e4-aae5-9bd98cee1dec","added_by":"auto","created_at":"2026-01-13 09:25:26","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":20001,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile1TableS1Microbiologicalpathogens.docx","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/03894b4305dcf32fc5985a01.docx"},{"id":100126610,"identity":"7f6cfc65-b00d-41da-9a5a-158c80a9d9fe","added_by":"auto","created_at":"2026-01-13 09:25:20","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":18311,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile2TableS2Classificationofpathogens.docx","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/c8dfa03c78ed2db199266c70.docx"},{"id":100126618,"identity":"4039c50d-ada5-4b0c-9c0f-d0f4c6a4b5b2","added_by":"auto","created_at":"2026-01-13 09:25:22","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":16716,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile3TableS3Antibiotictherapy.docx","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/f6386478e46c2b4eacf86b89.docx"},{"id":100126631,"identity":"b5a9ab19-c822-4dac-8990-74aea8e1f605","added_by":"auto","created_at":"2026-01-13 09:25:23","extension":"docx","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":17666,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile4TableS4Univariableregressionanalysis.docx","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/77ebea7358dcdb6db52e6887.docx"},{"id":100126627,"identity":"395e3bf9-d406-49a3-bc65-7cf3dd41c279","added_by":"auto","created_at":"2026-01-13 09:25:23","extension":"docx","order_by":7,"title":"","display":"","copyAsset":false,"role":"supplement","size":17498,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile5TableS5Multivariablelogisticanalysis.docx","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/bd08e247d10997450f593539.docx"},{"id":100366764,"identity":"c14bf69e-3295-485f-8f3c-b0b857745655","added_by":"auto","created_at":"2026-01-16 07:56:31","extension":"pdf","order_by":8,"title":"","display":"","copyAsset":false,"role":"supplement","size":250731,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile6FigS1Univariableregressionanalysis.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/995e998551fe81f7d1163f2c.pdf"},{"id":100365662,"identity":"bf5c0654-4652-43d4-8dc9-2be27989f70f","added_by":"auto","created_at":"2026-01-16 07:55:29","extension":"pdf","order_by":9,"title":"","display":"","copyAsset":false,"role":"supplement","size":268187,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile7FigS2Multivariableregressionanalysis.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8357670/v1/877cf701d5e304616ba8c45b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical differences and prognostic factors for unfavourable outcome in community-acquired versus health care-associated intracranial empyema and abscess","fulltext":[{"header":"Background","content":"\u003cp\u003eIntracranial empyema and brain abscess are rare but life-threatening infections of the central nervous system (CNS) that require immediate neurosurgical and antimicrobial treatment [\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Despite advances in neuroimaging, antimicrobial therapy, and intensive care, they remain associated with substantial morbidity and mortality, with reported case-fatality rates of 10–30% [\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe pathogenesis differs between community-acquired infections (CA), typically arising from contiguous spread of local infection, and health care-associated infections, which develop as complications of surgical interventions [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan additionalcitationids=\"CR9 CR10\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e–\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. These groups differ in their microbiological spectrum: streptococci and anaerobes usually predominate in CA cases, whereas \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and other hospital-acquired pathogens such as Gram-negative bacteria are more frequent in HCA patients [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e–\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This microbiological distinction is reflected in the current treatment recommendations of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), which advocate a third-generation cephalosporin combined with metronidazole for community-acquired infections, and meropenem or alternatively ceftazidime combined with vancomycin for post-neurological cases [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRecent studies employing advanced sequencing techniques rather than conventional culturing methods suggest the involvement of a broader range of pathogens within brain abscesses than previously suspected [\u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e–\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. However, the clinical relevance of these findings remains to be determined. Clinical presentation is often non-specific and ranges from headache and fever to focal neurological deficits, seizures, or altered consciousness [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Prognosis is influenced by timeliness of diagnosis, extent of infection, and systemic complications such as sepsis [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMost available studies, however, describe heterogeneous cohorts without stratifying by infection origin [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. CA infections usually affect younger, otherwise healthy patients, whereas HA cases occur in older patients with higher comorbidity burden and exposure to hospital pathogens [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. These fundamental differences suggest potentially distinct clinical courses and prognostic determinants [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Nevertheless, only a few studies directly compare intensive care requirements, microbial profiles, and neurological outcomes between the two entities [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEvidence regarding prognostic factors is also inconsistent. Some studies emphasize surgical status and comorbidities as outcome drivers, while others identify severity of the initial presentation—such as low Glasgow Coma Scale (GCS) or presence of sepsis—as the main determinant [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e–\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This uncertainty complicates early risk stratification and treatment decisions in clinical practice [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn light of these knowledge gaps, the objective of this study was to systematically investigate differences in clinical presentation, microbiology, intensive care management, and outcomes between patients with CA and HCA intracranial empyema or abscess.\u003c/p\u003e "},{"header":"Methods","content":"\u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eStudy Design and Setting.\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e\u003cp\u003e This retrospective, single-centre cohort study was conducted at the Institute for Intensive Care Medicine at the University Hospital Zurich, a tertiary care academic centre in Switzerland. Patient data were collected from January 2012 to January 2023.\u003c/p\u003e\u003ch3\u003e2) Study Population.\u003c/h3\u003e\u003cp\u003eThe study population comprised adult patients (≥ 18 years) with a diagnosis of intracranial empyema or abscess. Empyema and abscess were defined according to clinical and radiological criteria, following the Infectious Diseases Society of America (IDSA) recommendations [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Empyema was defined as a purulent collection within the subdural or epidural space, whereas abscess was defined as a localized, encapsulated infection within the brain parenchyma. Radiological findings were assessed using computed tomography (CT) and/or magnetic resonance imaging (MRI) and interpreted according to the recommendations of the Infectious Diseases Society [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe diagnosis was confirmed through radiological imaging and/or intraoperative neurosurgical findings. Patients were excluded from the study if they were under the age of 18, had no confirmed diagnosis, or had refused general consent.\u003c/p\u003e\u003cp\u003ePatients were stratified into two groups:\u003c/p\u003e\u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCommunity-acquired infections (CA)\u003c/b\u003e, defined as intracranial empyema or brain abscess not related to a previous neurosurgical intervention and typically arising from contiguous spread of sinusitis, otitis, or dental infections, or by haematogenous dissemination from distant sources such as endocarditis.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eHealth care-associated infections (HCA)\u003c/b\u003e, defined as intracranial empyema or brain abscess occurring after craniotomy or other neurosurgical procedures.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e\u003cp\u003eTo avoid immortal time bias, the observation period for all patients was defined as starting on the date of confirmed diagnosis of intracranial empyema or abscess. Observation time therefore began uniformly for both CA and HCA cases, independent of the timing of the initial hospital admission or neurosurgical procedure.\u003c/p\u003e\u003ch3\u003e3) Data Collection\u003c/h3\u003e\u003cp\u003eA comprehensive data extraction was conducted from the Neurosurgery Registry at the University Hospital Zurich [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], encompassing demographic, clinical, surgical, laboratory, radiological, microbiological, and outcome data. The data presented herein were obtained from electronic medical records and institutional databases (KISIM-TM, Cistec®, Zurich, Switzerland). The following variables were analysed: \u003cem\u003ebaseline characteristics\u003c/em\u003e, including age, sex, Charlson Comorbidity Index (CCI) [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], American Society of Anesthesiologists (ASA) classification, immune status, preexisting infectious disease, neurological symptoms at admission; data on \u003cem\u003einfection;\u003c/em\u003e including type and localization of infection, microbiological culture results, \u003cem\u003eimaging finding\u003c/em\u003es; \u003cem\u003echaracteristics of the intensive care unit stay\u003c/em\u003e, and \u003cem\u003eneurological functional outcomes\u003c/em\u003e at hospital discharge and at 3 to 6 months, as assessed with the Glasgow Outcome Scale-Extended (GOSE) [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The CCI is a validated scoring system that quantifies comorbidity burden by assigning weighted points to a range of chronic diseases such as cardiovascular, pulmonary, renal, hepatic, and oncological conditions. It provides an overall estimate of the patient’s baseline health status and risk of mortality [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eImmune status referred to the presence of human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), use of immunosuppressive medication (e.g. corticosteroids, calcineurin inhibitors, antimetabolites, or biologics), and underlying haematological or oncological disease. Patients with documented AIDS or with any of the other aforementioned conditions were designated as immunocompromised [\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e–\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The CCI was utilised to ascertain additional comorbidities with the potential to affect immune competence, including diabetes and chronic organ disease.\u003c/p\u003e\u003cp\u003eClinical presentation was evaluated by neurological symptoms and level of consciousness at admission using the Glasgow Coma Scale (GCS), a widely used and previously published neurological assessment tool [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], as well as serum inflammation markers. Symptom onset was defined as the earliest documented neurological or systemic symptom attributable to intracranial empyema or abscess. The onset date was extracted retrospectively from clinical documentation, including emergency department notes, neurology and neurosurgery assessments, as well as patient or relative history recorded by the treating physicians. Symptoms used to determine symptom onset comprised neurological and systemic signs typically associated with intracranial empyema or abscess, as extracted from retrospective clinical documentation.\u003c/p\u003e\u003cp\u003eMicrobiological results were collected from intraoperative specimens, cerebrospinal fluid, or blood cultures. Preexisting infectious disease was defined as a history of wound or soft tissue infection or antibiotic treatment, within six weeks prior to admission. This pragmatic definition was based on the categories of soft tissue infections described in the IDSA guidelines [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eICU-related variables included presence of sepsis or septic shock, need for mechanical ventilation, renal replacement therapy, vasopressors, and ICU length of stay. Sepsis and septic shock were defined in accordance with the international consensus guidelines (Sepsis-3) endorsed by the European Society of Intensive Care Medicine (ESICM) and the Society of Critical Care Medicine (SCCM) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e\u003cp\u003e Empirical antibiotic therapy was started with ceftriaxone and metronidazole -in case of CA infections- or vancomycin and ceftazidime or meropenem- in case of HCA infections- according to our internal guidelines, and subsequently tailored to microbiological results.\u003c/p\u003e\u003ch3\u003e4) Outcomes\u003c/h3\u003e\u003cp\u003eThe primary outcome was functional neurological status at hospital discharge and at 3–6 months, measured by the GOSE [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. GOSE was assessed during outpatient follow up or during neurorehabilitation based on the follow up visits or discharge letters from the rehabilitation hospital. Neurological outcomes were dichotomized as favourable (GOSE \u0026gt; 5) and unfavourable outcome (GOSE ≤ 4) [\u003cspan additionalcitationids=\"CR37\" citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e–\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Secondary outcomes included in-hospital mortality, ICU admission rate, length of stay, need for mechanical ventilation and vasopressors, and microbiological differences between groups.\u003c/p\u003e\u003ch3\u003e5) Statistical Analysis\u003c/h3\u003e\u003cp\u003eContinuous variables were summarised as median and interquartile range (IQR) and compared using the Mann–Whitney U test. Categorical variables were presented as counts and percentages and compared with the χ² test or Fisher’s exact test, as appropriate. Univariable logistic regression was performed to explore associations between clinical variables (age, sex, CCI, primary vs postoperative infection, GCS on admission, and sepsis) and unfavourable outcome. Variables with clinical relevance and statistical significance in univariable analyses were further examined in multivariable models. In addition, a separate multivariable logistic regression model was constructed to identify predictors of in-hospital mortality. All analyses were conducted using Python (version 3.11) with the packages \u003cem\u003epandas\u003c/em\u003e, \u003cem\u003estatsmodels\u003c/em\u003e, and \u003cem\u003escikit-learn\u003c/em\u003e. Graphical output was generated using \u003cem\u003ematplotlib\u003c/em\u003e and Prism 10.2.0 (GraphPad, La Jolla, CA, USA). Statistical significance was set at \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05.\u003c/p\u003e\u003ch3\u003e6) Data protection and ethics\u003c/h3\u003e\u003cp\u003e The study was conducted in accordance with the Declaration of Helsinki and approved by the Cantonal Ethics Committee Zurich (Kantonale Ethikkommission Zürich, KEK Zurich), Switzerland (BASEC-No. PB-2017-00093). Owing to the retrospective design of the study, the requirement for informed consent was waived by the ethics committee. Prior to analysis, all data were pseudonymised, and strict confidentiality was maintained throughout the study in compliance with institutional and national data protection regulations.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 131 patients diagnosed with intracranial empyema or abscess were initially screened from the Neurosurgery Registry at the University Hospital of Zurich [27]. The excluded patients are presented in Fig. 1. Overall, 84 patients had a confirmed diagnosis. These were categorised as CA (n= 37) and HCA (n= 47) as shown in Fig. 1.\u003c/p\u003e\n\u003cp\u003eBaseline characteristics are presented in Table 1. HCA patients were significantly older than those with CA infections (median 59 [IQR 48\u0026ndash;70] vs 52 [33\u0026ndash;63] years, p = 0.047). The time from symptom onset to diagnosis was longer for CA infections (median 4.0 [1.0\u0026ndash;8.0] vs. 1.0 [0.0\u0026ndash;5.0] days), although this trend was not significant (p = 0.067). The CCI was significantly higher in patients with HCA empyema/abscess than in those with CA (median 3.0 [IQR 1.0\u0026ndash;7.0] vs 2.0 [IQR 1.0\u0026ndash;3.0], p = 0.015) (Table 1).\u003c/p\u003e\n\u003cp\u003eCA patients presented more frequently with neurological symptoms, such as disturbed consciousness (29.7% vs. 10.6%, p = 0.048) and other CNS-related symptoms (64.9% vs. 29.8%, p = 0.002) (Table 2). The mean GCS at diagnosis was lower in the CA empyema/abscess group compared to the HCA cases (13.5 \u0026plusmn;3.0 vs. 14.7 \u0026plusmn;0.7, p = 0.024). There were significant differences in neurological symptoms at presentation between the groups. New-onset focal neurological deficits (FND) were markedly more frequent in patients with CA empyema/abscess than in HCA cases (78.4% vs. 40.4%, p = 0.001), particularly hemiparesis (40.5% vs. 14.9%, p = 0.012) and neglect (18.9% vs. 4.3%, p = 0.039) (Table 2).\u003c/p\u003e\n\u003cp\u003eCA empyema/abscesses were associated with paranasal sinusitis (18.9%), pathological cerebrospinal fluid (CSF) indicative of CNS infections (29.7%), dental/jawbone infections (10.8%), otitis/mastoiditis (10.8%), and endocarditis (8.1%) (Fig. 2). HCA empyema or abscess occurred mostly following primary tumour resection (n = 19, 40.4%), metastasis resection (n=10, 21.2%), and trauma (n=9, 19.1%). This was followed by vascular pathology (n=7, 15.5%) and epilepsy (n=2, 4.2%). Almost all procedures were supratentorial (n=46, 97.8%), with the majority being elective (n=34, 72.3%) rather than urgent (n=13, 27.7%). (Fig. 3).\u003c/p\u003e\n\u003cp\u003eAbscesses were more frequent in CA cases (86.5% vs. 44.7%, p \u0026lt; 0.001), whereas empyema was more frequent in HCA cases (66.0% vs. 24.3%, p \u0026lt; 0.001), including cases of multiple empyema localisations (19.1% vs. 2.7%, p = 0.037).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding infection characteristics, sepsis was significantly more frequent in patients with CA infections (43.2% vs. 21.3%, p = 0.036). Among the total study population, 22 patients underwent lumbar puncture with CSF analysis at admission. All showed evidence of inflammation, defined by pathological CSF findings (pleocytosis, elevated protein, low glucose, and/or high lactate). Positive CSF cultures were more frequently observed in the CA group, although this difference did not reach statistical significance (6.4% vs. 8.1%, p = 1.000). Osteomyelitis was significantly more frequently detected in HCA patients (36.2% vs. 2.7%, p \u0026lt; 0.001) (Table 3a). Among patients with positive cultures, the median number of pathogens per infection was higher in the CA than in the HCA infections (2 [IQR 1\u0026ndash;3] vs 1 [IQR 1\u0026ndash;2]), although this difference did not reach statistical significance (p = 0.19). Polymicrobial infections occurred in 56.8% of CA cases and 45.7% of HCA cases (p = 0.31) as shown in Table 3b and in Fig. 4. The microbiological spectrum differed markedly between the two groups. CA infections were dominated by \u003cem\u003eStreptococcus anginosus\u003c/em\u003e (n = 21, 56.8%), \u003cem\u003eAggregatibacter aphrophilus\u003c/em\u003e (n = 6, 16.2%), and \u003cem\u003eParvimonas micra\u003c/em\u003e (n = 6, 16.2%), followed by \u003cem\u003eStaphylococcus epidermidis\u003c/em\u003e (n = 6, 16.2%) and mixed anaerobic flora (n = 4, 10.8%). Less frequent isolates included \u003cem\u003eActinomyces\u003c/em\u003e spp., \u003cem\u003ePrevotella intermedia\u003c/em\u003e, \u003cem\u003eStreptococcus pneumoniae\u003c/em\u003e, and \u003cem\u003eFusobacterium necrophorum\u003c/em\u003e. \u003cem\u003eAspergillus\u003c/em\u003e spp. were detected in three patients, all within the CA group (3.6% of the total cohort); each was immunocompromised due to underlying oncological disease or immunosuppressive therapy (Table 3b).\u003c/p\u003e\n\u003cp\u003eIn contrast, HCA infections were primarily caused by \u003cem\u003eStaphylococcus aureus\u003c/em\u003e (n = 19, 41.3%), \u003cem\u003eCutibacterium acnes\u003c/em\u003e (n = 15, 32.6%), and \u003cem\u003eStaphylococcus epidermidis\u003c/em\u003e (n = 10, 21.7%), followed by \u003cem\u003eProteus mirabilis\u003c/em\u003e (n = 7, 15.2%) and \u003cem\u003eKlebsiella aerogenes\u003c/em\u003e (n = 6, 13.0%). Other occasionally isolated pathogens included \u003cem\u003eEnterobacter cloacae\u003c/em\u003e, \u003cem\u003eCitrobacter koseri\u003c/em\u003e, \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e, \u003cem\u003eDermabacter hominis\u003c/em\u003e, \u003cem\u003eEscherichia coli\u003c/em\u003e, and \u003cem\u003eNocardia beijingensis\u003c/em\u003e. One patient in this group had no pathogen identified.\u003c/p\u003e\n\u003cp\u003eIn the HCA infection group, a total of 10 isolates with chromosomally encoded AmpC \u0026beta;-lactamases were detected (\u003cem\u003eKlebsiella aerogenes\u003c/em\u003e = 6, \u003cem\u003eEnterobacter cloacae complex\u003c/em\u003e = 2, \u003cem\u003eSerratia marcescens\u003c/em\u003e = 1, \u003cem\u003eMorganella morganii\u003c/em\u003e = 1). This corresponds to 9 of 47 cases (19%), which were not optimally covered by the locally recommended initial therapy regimen of ceftazidime and vancomycin. 16S rRNA gene PCR or 18S rRNA gene PCR was performed only in cases with no growth in conventional culturing. Anaerobes may be underdiagnosed based on conventional culturing techniques used in routine microbiological diagnostics. None of the \u003cem\u003eStaphylococcus aureus\u003c/em\u003e isolates from either CA or HCA infections were methicillin-resistant (MRSA). Susceptibility profiles of all pathogens isolated via conventional culturing did not differ from those of the respective wild-type populations.\u003c/p\u003e\n\u003cp\u003eOverall, CA infections were characterized by oral commensals and anaerobes, whereas HCA infections were predominantly staphylococcal, \u003cem\u003eCutibacterium\u003c/em\u003e, and Gram-negative organisms typical of postoperative or nosocomial flora. The detailed distribution of pathogens is provided in Table 3b and in Supplementary Tables S1-2, and the administered antimicrobial regimens in Supplementary Table S3. The total duration of antibiotic therapy, including empirical and targeted treatment phases, was comparable between the groups.\u003c/p\u003e\n\u003cp\u003eAdmission to the ICU was significantly more frequent in patients with CA intracranial empyema/abscess than in HCA cases (81.0% vs. 31.9%, p \u0026lt; 0.001). The discharge destination differed, with HCA patients being more frequently discharged home (46.8% vs. 24.3%, p = 0.042), whereas patients with CA infections to a rehabilitation clinic (56.7% vs. 34.0%, p = 0.048). In terms of the clinical course, patients with CA infections had a significantly longer hospital stay than HCA cases (median 19 days [(IQR) 11\u0026ndash;26] \u0026nbsp;versus 12 days [IQR 8\u0026ndash;16], p = 0.002).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNeurological outcomes showed no significant differences at either discharge (median GOSE 7 vs. 6, p = 0.144) or at the 3\u0026ndash;6 month follow-up (median GOSE 7 in both groups, p = 0.377). Patients who died before the scheduled neurosurgical follow-up (n=7) were excluded from the GOSE analysis, as they were already classified as in-hospital deaths.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the univariable analysis, patients with unfavourable outcome at discharge had both a lower GCS at diagnosis and developed sepsis more frequently than patients with favourable outcome (Supplementary Table S4, Fig. S1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the multivariable logistic regression analysis only the SAPS II score was found to be a predictor for mortality (B = 0.18, OR = 1.20, 95% CI [1.05, 1.37], p = 0.009). After adjusting for severity scores, no significant association was found for age, sex, or other clinical features such as seizures, fever or CNS symptoms (Supplementary Table S5, Fig S2).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this single-centre retrospective study, we investigated differences between patients with CA and HCA intracranial empyema or abscess. As main findings, we reported that CA cases presented with more severe neurological impairment \u0026mdash;lower GCS, higher rates of focal neurological deficits and disturbed consciousness\u0026mdash; and were more often septic at admission. Consequently, they required more frequent and prolonged ICU treatment. Additionally, microbiological patterns also differed between the two entities: streptococci and oral anaerobes predominated in CA infections, whereas \u003cem\u003eStaphylococcus aureus\u003c/em\u003e and Gram-positive rods were characteristic of HCA cases. Polymicrobial growth was common in both entities (58% vs. 45%, p\u0026thinsp;=\u0026thinsp;0.31), suggesting that intracranial empyema frequently arises from mixed bacterial sources rather than single pathogens.\u003c/p\u003e \u003cp\u003eThe observed differences in disease severity at presentation may also, at least in part, reflect a diagnostic or detection bias. Patients with HCA infections are routinely monitored in the hospital, which may facilitate earlier recognition and management of infection. In contrast, patients with CA infections may present later, once neurological symptoms or systemic infection become evident. Although the time from symptom onset to diagnosis did not reach statistical significance in our cohort, a trend towards delayed diagnosis in CA cases could contribute to their more severe clinical presentation and higher rates of ICU admission.\u003c/p\u003e \u003cp\u003eDespite these differences, short- and long-term functional outcomes were comparable between groups, although one might expect that the underlying condition that led to surgery could also negatively affect outcome. This suggests that early intensive management can mitigate the adverse impact of severe initial presentation. By contrast, postoperative patients had a higher comorbidity burden and showed a non-significant trend toward higher in-hospital mortality. This finding underlines that comorbidities and baseline health status remain important, even when initial neurological status is preserved.\u003c/p\u003e \u003cp\u003eOur results highlight two key prognostic factors: initial neurological status and systemic infection severity (sepsis). Both were strongly associated with unfavourable outcomes, while demographic characteristics, comorbidities, and surgical status were less predictive. This is consistent with prior reports that stress the dominant role of disease severity at presentation over baseline characteristics in determining prognosis [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This aligns with previous studies on intracranial infections, which consistently emphasize the prognostic importance of disease severity at admission rather than baseline demographics or comorbidity burden [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. However, in the multivariable analysis only the SAPS II score remained as a predictor for in-hospital mortality probably due to the relatively small sample size of our population.\u003c/p\u003e \u003cp\u003eThe finding that patients with HCA infections had a higher comorbidity burden highlights the importance of optimising patients before surgery and implementing preventive strategies during the perioperative period. A careful preparation of patients before elective neurosurgical procedures may help to reduce the risk of postoperative empyema or abscess. Therefore, optimising modifiable comorbidities, such as for example achieving good glycaemic control in diabetic patients should be integrated into surgical planning and perioperative care.\u003c/p\u003e \u003cp\u003eGiven the heterogeneous presentation and multifactorial pathogenesis of intracranial empyema and abscess, future research should aim to develop predictive models for postoperative infection risk following neurosurgical procedures [\u003cspan additionalcitationids=\"CR40\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Such models could integrate perioperative clinical characteristics \u0026mdash; including comorbidity burden, surgical type, and microbiological risk factors\u0026mdash; to identify patients at highest risk of postoperative infection. The utilisation of prospective multicentre datasets and machine-learning approaches holds potential in refining prediction scores and guiding targeted preventive strategies within the domain of neurosurgical practice [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe main strength of this study lies in the analysis of a dataset of detailed information on patients with both CA and HCA brain empyema and abscesses, including clinical presentation, symptoms, microbiological parameters, ICU-treatment, and outcomes. This comprehensive approach allows for direct comparisons between the two entities. The principal limitations are the retrospective nature of the analysis and that the data are derived from a single centre, which restricts the generalizability of the findings. Additionally, we were unable to perform a dedicated sub-analysis comparing empyema and abscess within each group (CA vs HCA) because of small subgroup sizes and an increased risk for both type II error and type I error, given the retrospective and exploratory study design. Finally, due to the relatively small sample size, it was not possible to perform a propensity-matched analysis in order to control for baseline differences between the groups. Consequently, the possibility of residual confounding and selection bias cannot be excluded.\u003c/p\u003e \u003cp\u003eIn summary, our findings suggest that CA and HCA intracranial empyema represent clinically distinct entities with different presentations and microbiological patterns. Nevertheless, their medium-term neurological outcomes may converge if early recognition, timely neurosurgical source control, and comprehensive intensive care support are ensured.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eCA intracranial empyema and brain abscess are associated with more severe neurological and systemic manifestations than HCA empyema or abscess and necessitate more intensive ICU support. Nevertheless, long-term functional outcomes appear comparable, provided that timely neurosurgical and comprehensive intensive care management are initiated. Our findings underscore that initial neurological status and the presence of sepsis represent the key prognostic determinants, whereas demographic factors, comorbidity burden, and surgical status seem to play a less decisive role. Distinct microbiological profiles underline the need for tailored empirical therapy and reinforce the importance of early culture-guided antimicrobial adjustment.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eASA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAmerican Society of Anaesthesiologists classification\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCommunity\u0026ndash;acquired\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCharlson Comorbidity Index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCHD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCoronary heart disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eConfidence interval\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCNS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCentral nervous system\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOPD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eChronic obstructive pulmonary disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCSF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCerebrospinal fluid\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eComputed tomography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCVA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCerebrovascular accident\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEEG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eElectroencephalogram\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eESCMID\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEuropean Society of Clinical Microbiology and Infectious Diseases\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFND\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFocal neurological deficit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGeneral consent\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGCS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlasgow Coma Scale\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGOSE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlasgow Outcome Scale\u0026ndash;Extended\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealth care\u0026ndash;associated\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHIV\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHuman immunodeficiency virus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICU\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntensive care unit\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIQR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eInterquartile range\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKISIM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKlinisches Informationssystem (institutional electronic medical record)\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLOS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLength of stay\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMRI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMagnetic resonance imaging\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMRSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMethicillin\u0026ndash;resistant Staphylococcus aureus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOdds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePCR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePolymerase chain reaction\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePVD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePeripheral vascular disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSAPS II\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSimplified Acute Physiology Score II\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSOFA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSequential Organ Failure Assessment score\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTIA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eTransient ischaemic attack\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eCompeting Interests\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e \u003c/p\u003e \u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e \u003cp\u003e The study was approved by the Cantonal Ethics Committee Zurich (Kantonale Ethikkommission Z\u0026uuml;rich, KEK Zurich), Switzerland (BASEC-No. PB-2017-00093). Owing to the retrospective design of the study and the use of pseudonymised routinely collected clinical data, the requirement for informed consent was waived by the ethics committee. The study was conducted in accordance with the principles of the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis research received no external funding.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eR.S.H. and G.B. conceptualized the study.R.S.H. and G.B. developed the methodology.R.S.H. performed the formal analysis.R.S.H., M.G., M.S., J.S., S.D.B., and D.W. contributed to the investigation.R.S.H., M.G., and D.W. curated the data.R.S.H. generated and prepared all figures, and D.W. generated Fig. 4.R.S.H. prepared all tables.R.S.H. drafted the original manuscript.All authors contributed to the review and editing of the manuscript.G.B. supervised the study.All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe would like to express our gratitude to the staff of the Department of Neurosurgery and the Institute of Intensive Care Medicine at the University Hospital Zurich for their assistance with data retrieval and documentation. We would also like to express our gratitude to the members of the Neurosurgery Registry team for granting us access to the dataset used in this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated and analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMoorthy RK, Rajshekhar V. Management of brain abscess: An overview. NeuroSurg Focus. 2008;24(6):E3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3171/FOC/2008/24/6/E3\u003c/span\u003e\u003cspan address=\"10.3171/FOC/2008/24/6/E3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrouwer MC, Tunkel AR, McKhann GM, van de Beek D. Brain Abscess. 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Springer-Verlag Wien; 2018. pp. 29\u0026ndash;38. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00701-017-3385-8\u003c/span\u003e\u003cspan address=\"10.1007/s00701-017-3385-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003ePatient characteristics in community-acquired versus health care-associated intracranial empyema/abscess.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"bottom\" style=\"width: 175px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 430px;\"\u003e\n \u003cp\u003eIntracranial empyema/abscess (n=84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 192px;\"\u003e\n \u003cp\u003eHCA (n=47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 238px;\"\u003e\n \u003cp\u003eCA (n=37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 70px;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 55px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e59\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(48-70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e57.3 (\u0026plusmn;15.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e52\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(33-63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;49.5 (\u0026plusmn;18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.047\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e19 (40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e14 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.987\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eSAPS II score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e18\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(15-25.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e19.5 (\u0026plusmn;7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e16 (15-29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e22.3 (\u0026plusmn;14.6)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.874\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eSOFA score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e0.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(0.0-1.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.8 (\u0026plusmn;1.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(0.0-3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e1.9 (\u0026plusmn;2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eASA classification\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e17 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e16 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eIII\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e24 (51.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e10 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eTotal CCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e3.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(1.0-7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.8 (\u0026plusmn;3.0)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e2.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(1.0-3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;2.1 (\u0026plusmn;2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eHistory of MI or CHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eHistory of CHF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.040\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eHistory of PVD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eCVA or TIA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e6 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.032\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eHistory of dementia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eCOPD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eConnective tissue disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003ePeptic ulcer disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eChronic liver disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eDiabetes mellitus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.694\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eDiabetes mellitus end-organ damage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eHemiplegia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eChronic kidney disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eSolid tumour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e18 (38.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eMetastatic solid tumour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eLeukaemia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.440\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eLymphoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003eAIDS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eHIV infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eAlcohol abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eIntravenous drug abuse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.034\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eChronic hepatitis C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eChronic hepatitis B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eImmunosuppression\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e5 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.232\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003eSymptoms to diagnosis (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e1.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(0.0-5.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e4.9 (\u0026plusmn;10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e4.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(1.0-8.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e6.8 (\u0026plusmn;9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 605px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCommunity-acquired (CA) infections were defined as intracranial empyema or abscess arising from contiguous or haematogenous spread in the absence of prior neurosurgical procedures. Health care-associated (HCA) infections were defined as postoperative intracranial empyema or abscess following neurosurgical intervention. Data are presented as number (percentage), mean \u0026plusmn; standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher\u0026rsquo;s exact test for categorical variables and Mann\u0026ndash;Whitney U test for continuous variables, according to data distribution. Abbreviations: ASA, American Society of Anaesthesiologists classification; SAPS II, Simplified Acute Physiology Score II; SOFA, Sequential Organ Failure Assessment score; CCI, Charlson Comorbidity Index; MI, myocardial infarction; CHD, coronary heart disease; PVD, peripheral vascular disease; CVA, cerebrovascular accident; TIA, transient ischaemic attack; COPD, chronic obstructive pulmonary disease; HIV, human immunodeficiency virus; AIDS, acquired immune deficiency syndrome.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Clinical presentation, neurological characteristics, and type of infection at admission.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"614\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 415px;\"\u003e\n \u003cp\u003eIntracranial empyema/abscess (n=84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 180px;\"\u003e\n \u003cp\u003eHCA (n=47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 236px;\"\u003e\n \u003cp\u003eCA (n=37)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinical characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eFever \u0026ge; 38.2\u0026deg;C\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e13 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e10 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eGCS on day of diagnosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e14.7 (\u0026plusmn;0.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e15\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(15-15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e13.5 (\u0026plusmn;2.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e15\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(14-15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.024\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eHeadache\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e21 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e16 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eEmesis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.398\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eMalaise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e5 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.498\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eDisturbance of consciousness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e11 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCNS symptoms and signs\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e14 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e24 (64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eAnisocoria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eMeningism\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eFND new onset\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e19 (40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e29 (78.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eHemiparesis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e15 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.012\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eHypo- hyperesthesia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e7 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e8 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eAphasia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eVisual field defects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.398\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eCoordination disturbance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e6 (12.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eCranial nerve dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eNeglect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.039\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eDysarthria\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e5 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eSeizures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e8 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e13 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eEEG on admission\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eICP monitoring\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e0.173\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of infection\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAbscess\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e21 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e32 (86.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eEmpyema\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e31 (66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e9 (24.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eAbscess + empyema\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e5 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 56px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eClinical presentation, neurological characteristics, and infection type at admission in community-acquired (CA) versus health care-associated (HCA) intracranial empyema or abscess. Data are presented as number (percentage), mean \u0026plusmn; standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher\u0026rsquo;s exact test for categorical variables and Mann\u0026ndash;Whitney U test for continuous variables, according to data distribution. CNS symptoms include focal neurological deficits, meningism, seizures, and cranial nerve dysfunction. Abbreviations: GCS, Glasgow Coma Scale; CNS, central nervous system; CSF, cerebrospinal fluid; FND, focal neurological deficit; EEG, electroencephalogram; ICP, intracranial pressure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3.\u003c/strong\u003e Infectious and microbiological characteristics of community-acquired versus health care\u0026ndash;associated intracranial empyema/abscess.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"973\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(a)\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eClinical infectious features\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 472px;\"\u003e\n \u003cp\u003eIntracranial empyema/abscess (n=84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 180px;\"\u003e\n \u003cp\u003eHCA (n=47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003eCA (n=37)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 180px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSepsis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e10 (21.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e16 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eSeptic shock\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e1 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePositive blood cultures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e4 (8.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePositive CSF cultures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e3 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePositive wound/abscess culture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e47 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e35 (94.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eOsteomyelitis\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e17 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 341px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 973px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(b)\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eMicrobiological profiles of culture-positive cases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003ePositive cultures of empyema/abscess (n=83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003eHCA (n=46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 195px;\"\u003e\n \u003cp\u003eCA (n=37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 195px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cem\u003ep- value\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eStaphylococcus aureus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e19 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eCutibacterium acnes\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e15 (32.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eStaphylococcus epidermidis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e10 (21.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eStreptococcus anginosus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e21 (56.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eAggregatibacter aphrophilus\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eParvimonas micra\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eProteus mirabilis\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e7 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eKlebsiella aerogenes\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e6 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eMixed anaerobic flora\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eActinomyces spp.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eStreptococcus pneumoniae\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.085\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cem\u003eAspergillus spp.\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003eOther Gram-negative rods (incl. AmpC-producing species)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e5 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonomicrobial infections\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e25 (54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e16 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePolymicrobial infections\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e21 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e21 (56.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMedian number of pathogens (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 134px;\"\u003e\n \u003cp\u003e1 (1-2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e2 (1-3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e(a) Clinical infectious features including sepsis, septic shock, culture positivity from blood, cerebrospinal fluid (CSF), and wound or abscess samples, as well as the presence of osteomyelitis. (b) Microbiological profiles of culture-positive empyema or abscess cases. One health care-associated (HCA) infection showed no microbial growth and was therefore excluded from the microbiological analysis (HCA n = 46; community-acquired [CA] n = 37). Data are presented as number (percentage), mean \u0026plusmn; standard deviation (SD), or median with interquartile range (IQR), as appropriate. Group comparisons were performed using Fisher\u0026rsquo;s exact test for categorical variables and the Mann\u0026ndash;Whitney U test for continuous variables, according to data distribution.\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Brain abscess, Community-acquired infection, Glasgow Outcome Scale-Extended (GOSE), Health care-associated infection, Intensive care, Intracranial empyema, Microbiology, Neurological outcome, Prognostic factors, Sepsis","lastPublishedDoi":"10.21203/rs.3.rs-8357670/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8357670/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eIntracranial empyema and brain abscess are rare but severe central nervous system infections. Community-acquired (CA) cases typically arise from sinus, otogenic, dental, or haematogenous sources, whereas health care-associated (HCA) infections occur as postoperative complications following neurosurgical interventions. Comparative data between these entities remain limited. This study assessed clinical presentation, microbiology, intensive care requirements, and outcomes in CA versus HCA infections and identified predictors of unfavourable neurological outcome.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted a retrospective single-centre study of adults treated for intracranial empyema or abscess at the University Hospital Zurich (2012\u0026ndash;2023). Patients were categorised as CA or HCA. Demographic, clinical, radiological, microbiological, and ICU variables were analysed. The primary outcome was neurological function at discharge and 3\u0026ndash;6 months using the Glasgow Outcome Scale\u0026ndash;Extended (GOSE). Secondary outcomes included ICU admission, in-hospital mortality, and microbiology. Logistic regression identified predictors of unfavourable outcome.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eEighty-four patients were included (37 CA, 47 HCA). CA patients were younger (52 vs 59 years; p\u0026thinsp;=\u0026thinsp;0.047), presented with lower GCS (13.5 vs 14.7; p\u0026thinsp;=\u0026thinsp;0.024), more frequently had new focal neurological deficits (78.4% vs 40.4%; p\u0026thinsp;=\u0026thinsp;0.001), disturbances of consciousness (29.7% vs 10.6%; p\u0026thinsp;=\u0026thinsp;0.048), and sepsis (43.2% vs 21.3%; p\u0026thinsp;=\u0026thinsp;0.036). ICU admission (81.0% vs 31.9%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and hospital stay (19 vs 12 days; p\u0026thinsp;=\u0026thinsp;0.002) were higher in CA patients. Microbiology differed substantially: \u003cem\u003eStaphylococcus aureus\u003c/em\u003e was more common in HCA infections (44.7% vs 8.1%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), whereas \u003cem\u003eStreptococcus spp.\u003c/em\u003e predominated in CA infections (64.9% vs 4.3%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Functional outcomes were comparable between groups at discharge (GOSE 7 vs 6; p\u0026thinsp;=\u0026thinsp;0.144) and follow-up (7 vs 7; p\u0026thinsp;=\u0026thinsp;0.377). Sepsis (p\u0026thinsp;=\u0026thinsp;0.003) and low GCS at diagnosis (p\u0026thinsp;=\u0026thinsp;0.006) predicted unfavourable outcome in univariable analysis; only SAPS II independently predicted mortality (OR 1.20 per point; 95% CI 1.05\u0026ndash;1.37; p\u0026thinsp;=\u0026thinsp;0.009).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eCA infections presented with more severe neurological and systemic impairment but achieved similar long-term functional outcomes as HCA infections. Prognosis appears to depend primarily on initial disease severity rather than infection origin or comorbidity burden.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eNot applicable (retrospective study)\u003c/p\u003e","manuscriptTitle":"Clinical differences and prognostic factors for unfavourable outcome in community-acquired versus health care-associated intracranial empyema and abscess","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-13 09:23:54","doi":"10.21203/rs.3.rs-8357670/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"3843995929426477715685204729448723978","date":"2026-01-14T03:09:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-11T07:41:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89068292753385311311305362751208749115","date":"2026-01-09T07:24:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-09T07:24:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"257035500833984720386444714575921303200","date":"2026-01-09T01:14:32+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-09T00:42:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"333232366542341154822581195923313575706","date":"2026-01-09T00:35:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"23242922750375199433065008775310419753","date":"2026-01-08T17:20:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-08T12:23:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-08T12:14:41+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-26T05:44:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-21T13:01:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Neurology","date":"2025-12-21T12:52:41+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"03659a04-30f1-466e-a793-fe95436b8fcc","owner":[],"postedDate":"January 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-13T09:23:55+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-13 09:23:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8357670","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8357670","identity":"rs-8357670","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}