Inflammatory Markers in Serum and Cerebrospinal Fluid for Early Detection of External Ventricular Drain-associated Ventriculitis in Patients With Subarachnoid Hemorrhage

Journal of Neurosurgical Anesthesiology
Markus LenskiNiklas Thon

Abstract

External ventricular drain (EVD)-associated ventriculitis is a serious complication. Early diagnosis can be difficult particularly in critically ill patients with aneurysmal subarachnoid hemorrhage (aSAH). We examined the diagnostic potential of standard serum and cerebrospinal fluid (CSF) biomarkers to differentiate between EVD-associated infections and aseptic courses in patients with aSAH. We retrospectively evaluated the levels of inflammatory markers in serum (white blood cell count, percentage of neutrophils [sN%], and procalcitonin) and CSF (total leukocyte count [CSFTLC], CSFglucose, CSF/serumglucose ratio, CSF total protein [CSFTP]) of 63 consecutive patients with aSAH. Receiver operating characteristic curves and the area-under-the-curve (AUC) were calculated to detect the diagnostic potential, optimized threshold, sensitivity (SE), specificity (SP), + likelihood ratio (LR), and -LR of each biomarker. Of all patients, 17 (27%) developed an EVD-associated ventriculitis within a mean of 7.8±2.3 days after implantation. sN% had a very good diagnostic potential (AUC=0.900, SE=70.0%, SP=100%), followed by the CSFTLC with good diagnostic potential (AUC=0.841, SE=75.0%, SP=88.5%), and the CSFTP with moderate diagnostic poten...Continue Reading

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Citations

Jan 24, 2020·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak
May 31, 2019·Neurocritical Care·Sherry H-Y ChouUNKNOWN Unruptured Intracranial Aneurysms and SAH CDE Project Investigators
Jul 4, 2019·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Peyton L NissonRein Anton

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Methods Mentioned

BETA
sedation

Software Mentioned

Statistical Package for the Social Sciences ( SPSS

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