Predictors of ventriculostomy infection in a large single-center cohort.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Sweid, A; Weinberg, JH; Abbas, R; El Naamani, K; Tjoumakaris, S; Wamsley, C; Mann, EJ; Neely, C; Head, J; Nauheim, D; Hauge, J; Gooch, MR; Herial, N; Zarzour, H; Alexander, TD; Missios, S; Hasan, D; Chalouhi, N; Harrop, J; Rosenwasser, RH; Jabbour, P

Published Date

  • April 10, 2020

Published In

Volume / Issue

  • 134 / 3

Start / End Page

  • 1218 - 1225

PubMed ID

  • 32276249

Electronic International Standard Serial Number (EISSN)

  • 1933-0693

Digital Object Identifier (DOI)

  • 10.3171/2020.2.JNS192051


  • eng

Conference Location

  • United States