Risk factors for infections related to external ventricular drainage
BACKGROUND External ventricular drainage (EVD) is the most common method of treatment for patients with increased intracranial pressure due to acute hydrocephalus. The most frequent complications of EVD are infections of the central nervous system. Earlier studies indicated numerous risk...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Slovenian Medical Association
2012-01-01
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| Series: | Zdravniški Vestnik |
| Online Access: | http://vestnik.szd.si/index.php/ZdravVest/article/view/553 |
| Summary: | BACKGROUND
External ventricular drainage
(EVD) is the most common method of treatment
for patients with increased intracranial pressure
due to acute hydrocephalus. The most frequent
complications of EVD are infections of the central
nervous system. Earlier studies indicated numerous
risk factors, although the results of studies
regarding the impacts of individual factors on
the occurrence of infections differ. Our research
was aimed at finding the risk factors for infection
in patients with an inserted EVD, treated at
the Department of Neurosurgery of University
Medical Centre (UMC) Ljubljana.
METHODS
In the article we describe a retrospective
research of EVDs inserted in the period
from January 2000 to January 2009. Forty-eight
cases of EVDs met the study inclusion criteria.
Among them, there were 10 cases with an infection
which occurred during inserted EVD. We
recorded, compared and evaluated information
about the patient, the EVD and infections.
RESULTS
The duration of the drainage was
confirmed as a risk factor for EVD infections
(p = 0.004). The infection occurred on average
on day 8.9 ± 5.4. The shares of subarachnoid and
intraventricular hemorrhage, previous neurosurgical
procedures, EVD manipulations, number
of successive drainages and duration of hospitalization
were greater in the cases of infected
EVDs. In the cases of EVD exchange, the average
day of change in group without infection was day
10.9 ± 5.8 (p = 0.030). Among infectious agents,
Gram-positive bacteria prevailed.
CONCLUSIONS
Strict asepsis is advised during insertion
and handling of EVD and a prophylactic
exchange of EVD on day 10 of insertion. Risk
factors in our study do not differ from findings
in other studies. Therefore it is suggested that
prophylactic measures against drain-related infection
should be developed and implemented
and their efficacy confirmed in a prospective
study. |
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| ISSN: | 1318-0347 1581-0224 |