Lumbar Drain Infection Rates: A Comprehensive Risk Factor Analysis From a Multicenter Retrospective Study of 1000+...

Area of Science:

• Neurosurgery
• Infectious Disease Epidemiology
• Patient Safety

Background:

• Lumbar drains (LDs) are crucial for cerebrospinal fluid (CSF) diversion in neurosurgery.
• Infection following LD insertion is a serious complication, leading to increased morbidity.
• Understanding risk factors is vital for preventing LD-associated infections.

Purpose of the Study:

• To evaluate the incidence and etiology of lumbar drain infections.
• To identify risk factors associated with LD infections across multiple neurosurgical units.
• To inform strategies for reducing infection rates in patients with LDs.

Main Methods:

• Retrospective multicenter cohort study of adult patients requiring LDs (January 2009 - February 2024).
• Analysis of demographic, clinical, and microbiological data.
• Multivariate logistic regression used to identify significant risk factors for LD infection.

Main Results:

• Overall LD infection rate was 11.4% (116/1017 patients).
• Significant risk factors included preoperative oral steroid use, prolonged drain duration, out-of-hours surgery, and CSF leaks.
• Factors reducing risk included insertion during primary surgery and specific reasons for insertion.

Conclusions:

• This study provides a comprehensive analysis of factors influencing LD infections in a large neurosurgical patient cohort.
• Recommendations include prioritizing LD insertion during primary surgery and minimizing drain duration.
• Prompt removal of disconnected drains and avoiding unnecessary sampling are key to infection prevention.