External ventricular drain practice variations: results from a nationwide survey

Area of Science:

• Neurosurgery
• Infectious Disease Prevention
• Medical Practice Standardization

Background:

• External ventricular drain (EVD) insertion is a common neurosurgical procedure.
• Current guidelines for EVD insertion are not universally standardized.
• Lack of standardization may contribute to variable patient outcomes and infection rates.

Purpose of the Study:

• To survey neurosurgeons regarding their practices for EVD insertion.
• To identify the most frequent EVD insertion techniques and protocols.
• To assess the prevalence of EVD-associated infections and prevention methods.

Main Methods:

• A survey was distributed to 7217 neurosurgeons via the American Association of Neurological Surgeons.
• 1143 respondents (15.8%) completed the 16-question survey.
• Data were analyzed using descriptive statistics and chi-square tests.

Main Results:

• Significant heterogeneity exists in EVD insertion practices among neurosurgeons.
• Only 42.7% of institutions utilize a formal EVD placement protocol, with inconsistent adherence.
• Self-reported infection rates varied, with 56.1% reporting 1-3% and 19.7% reporting 0%.

Conclusions:

• Neurosurgical EVD insertion practices are highly variable and lack standardization.
• There is a clear need for nationwide standardization of EVD insertion techniques and complication prevention strategies.
• Standardization could lead to improved patient safety and reduced infection rates.