Bilateral External Ventricular Drains Increase Ventriculostomy-Associated Cerebrospinal Fluid Infection in Low Modified Graeb Score Intraventricular Hemorrhage

World Neurosurgery
Wen-Jian ZhengShao-Hua Lin

Abstract

Ventriculostomy-associated cerebrospinal fluid infection (VAI) is a major complication limiting the use of an external ventricular drain (EVD) in treating patients with intraventricular hemorrhage (IVH). Risk factors of VAI are still under wide discussion. We performed a retrospective review of 84 patients with IVH who underwent EVD at our center between January 2012 and January 2017. Preoperative clinical parameters, surgeon status, number of catheters and catheter-days, subgaleal tunneling distance, frequency of urokinase flush, and prophylactic antibiotics were compared between the infective and noninfective groups. The overall rate of VAI was 31.0%. Univariate analysis showed a higher modified Graeb Score (mGS), higher proportion of bilateral catheters, and longer hospital stay in patients with VAI. Binary logistic analysis of all clinical factors identified high mGS (≥16) as an independent risk factor for VAI (odds ratio, 3.242; P = 0.026). Among operative and postoperative factors, the use of bilateral catheters significantly contributed to VAI (odds ratio, 4.211; P = 0.031), but a subgroup comparison showed an increased VAI rate only in the low mGS group (mGS <15). No VAI occurred in patients with a single EVD in the low...Continue Reading

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Citations

Jan 30, 2020·Expert Review of Anti-infective Therapy·Kirsten R I S DorresteijnDiederik van de Beek
Feb 25, 2020·The Journal of Infection·Kirsten R I S DorresteijnKorné Jellema

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