Analysis on risk factors of catheter-related infections of external ventricular drainage

Abstract

Objective To explore the risk factors of catheter-related infections of external ventricular drainage (EVD) , so as to provide evidence for effective prevention and control measures. Methods A total of 428 patients′ clinical data were collected by retrospective case analysis in cluster sampling, who underwent external ventricular drainage in Neurosurgery Department of a class Ⅲ grade A hospital in Shanghai from January 2014 to October 2016. The incidence of EVD infection was analyzed. At the same time, univariate analysis and multivariate Logistic regression analysis were adopted for risk factors of EVD related infection. Results The catheter-related ventricular infections occurred in 36 of 428 cases of patients, with the incidence rate 8.41%. The detection rate of pathogens in cerebrospinal fluid was 75.00%, and Gram-negative bacteria were the main pathogens (78.13%) , among which the most common was Acinetobacter baumannii (28.11%) . Univariate analysis showed that the incidence of catheter-related ventricular infection was related to gender, age, admission diagnosis, diabetes mellitus, preoperative pulmonary infection, Glasgow Coma Scale (GCS) score, American Society of Anesthesiologists (ASA) physical status classification, duration of EVD, type of EVD, number of catheters, frequency of replacing catheter, frequency of sampling cerebrospinal fluid (P<0.05) . Multivariate Logistic regression suggested that duration of EVD, number of catheters, pulmonary infection and frequency of sampling cerebrospinal fluid were independent risk factors causing catheter-related ventricular infection (OR=1.070, 13.236, 6.800, 6.248) . Conclusions The catheter-related ventricular infection can be caused by single factor or the synergistic action of multiple factors. The control of pulmonary infection and the management of blood glucose level are helpful to reduce the infection of EVD related infection. Key words: Risk factors; Neurosurgical procedures; External ventricular drainage; Catheter-related infection