Predictors of ventriculostomy infection in a large single-center cohort.
Publication/Presentation Date
3-1-2021
Abstract
OBJECTIVE: External ventricular drain (EVD) placement is a common neurosurgical procedure. While this procedure is simple and effective, infection is a major limiting factor. Factors predictive of infection reported in the literature are not conclusive. The aim of this retrospective, single-center large series was to assess the rate and independent predictors of ventriculostomy-associated infection (VAI).
METHODS: The authors performed a retrospective chart review of consecutive patients who underwent EVD placement between January 2012 and January 2018.
RESULTS: A total of 389 patients were included in the study. The infection rate was 3.1% (n = 12). Variables that were significantly associated with VAI were EVD replacement (OR 10, p = 0.001), bilateral EVDs (OR 9.2, p = 0.009), duration of EVD placement (OR 1.1, p = 0.011), increased CSF output/day (OR 1.0, p = 0.001), CSF leak (OR 12.9, p = 0.001), and increased length of hospital stay (OR 1.1, p = 0.002). Using multivariate logistic regression, independent predictors of VAI were female sex (OR 7.1, 95% CI 1.1-47.4; p = 0.043), EVD replacement (OR 8.5, 95% CI 1.44-50.72; p = 0.027), increased CSF output/day (OR 1.01, 95% CI 1.0-1.02; p = 0.023), and CSF leak (OR 15.1, 95% CI 2.6-87.1; p = 0.003).
CONCLUSIONS: The rate of VAI was 3.1%. Routine CSF collection (every other day or every 3 days) and CSF collection when needed were not associated with VAI. The authors recommend CSF collection when clinically needed rather than routinely.
Volume
134
Issue
3
First Page
1218
Last Page
1225
ISSN
1933-0693
Published In/Presented At
Sweid, A., Weinberg, J. H., Abbas, R., El Naamani, K., Tjoumakaris, S., Wamsley, C., Mann, E. J., Neely, C., Head, J., Nauheim, D., Hauge, J., Gooch, M. R., Herial, N., Zarzour, H., Alexander, T. D., Missios, S., Hasan, D., Chalouhi, N., Harrop, J., Rosenwasser, R. H., … Jabbour, P. (2020). Predictors of ventriculostomy infection in a large single-center cohort. Journal of neurosurgery, 134(3), 1218–1225. https://doi.org/10.3171/2020.2.JNS192051
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
32276249
Department(s)
Administration and Leadership
Document Type
Article