Risk factors for external ventricular drainage infections

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.

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.

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.

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.