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Influence of Ward Environments on External Ventricular Drain Infections: A Retrospective Risk Factor Analysis.

Yuanrun Zhu1, Liang Wen1, Wendong You1

  • 1The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang Province, China.

Surgical Infections
|May 1, 2020
PubMed
Summary
This summary is machine-generated.

Ventriculostomy-related infections (VRIs) are linked to longer intensive care unit (ICU) stays, frequent cerebrospinal fluid (CSF) sampling, prolonged external ventricular drain (EVD) duration, and pre-operational intubation. Multi-bed accommodation did not significantly increase VRI risk.

Keywords:
CSF samplingICU stayduration of placementexternal ventricular drainrisk factorsventriculostomy-related infection

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Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Ventriculostomy-related infection (VRI) is a significant complication of external ventricular drains (EVDs).
  • The influence of the ward environment and other potential risk factors on VRI remains incompletely understood.
  • Identifying modifiable risk factors is crucial for preventing EVD infections.

Purpose of the Study:

  • To evaluate the ward environment, specifically multi-bed accommodation and intensive care unit (ICU) stay, as potential risk factors for VRI.
  • To confirm previously identified risk factors associated with EVD infections.
  • To identify independent risk factors for VRI to inform preventative strategies.

Main Methods:

  • Retrospective review of patients undergoing EVD procedures between January 2012 and January 2017.
  • Univariable and logistic regression analyses were employed to identify risk factors for VRI.
  • Data collected included patient demographics, clinical characteristics, and EVD management details.

Main Results:

  • Of 284 patients, 12.7% developed VRI.
  • Independent risk factors for VRI included longer post-operational ICU stay (>5 days, OR=3.21), frequent CSF sampling (>3, OR=5.14), longer EVD duration (>7 days, OR=3.85), and pre-operational artificial airway status (OR=2.85).
  • Multi-bed accommodation did not show a statistical difference in VRI rates (p=0.404).

Conclusions:

  • Prolonged ICU stay, frequent CSF sampling, extended EVD duration, and pre-operational intubation are significant independent risk factors for VRI.
  • Ward environment factors like multi-bed accommodation do not appear to substantially influence VRI risk.
  • These findings highlight key factors for targeted VRI prevention protocols.