Risk factors for external ventricular drainage infections

Abstract

Introduction: External ventricular drainage (EVD) is frequently used in neurosurgical interventions to drain cerebrospinal fluid (CSF). Nevertheless, it carries a high incidence of infectious complications, notably secondary meningitis and ventriculitis. In light of the previous rates of these EVD-related infections, we introduced a set of guidelines to lower the infection rate. This study aimed to assess the influence of the hospital-wide adoption of the EVD handling protocol on secondary infections related to EVD.

Material and methods: We enrolled 171 patients scheduled for EVD placement for reasons other than infectious meningitis or ventriculitis from January 2021 to March 2024. A matched cohort of patients underwent logistic regression to adjust for and analyze regression discontinuity.

Results: Infections were more prevalent in the group before the protocol's implementation (18.27% compared to 7.46%, p<0.0001). Regression analysis within the matched score cohort (n=104 in pre-protocol groups and n=67 in post-protocol groups) indicated that the period before the protocol was independently linked to a higher incidence of infections.

Conclusion: Implementing a stringent hospital-wide protocol for EVD handling can significantly diminish the rate of secondary infections associated with EVD (Tab. 3, Fig. 1, Ref. 15). Text in PDF www.elis.sk Keywords: external ventricular drainage, meningitis, ventriculitis, infection.