External Ventricular Drainage Infections Rates: Clinic Experiences

Serdar Çevik,Hakan Hanımoğlu,Enes Akkaya,Celaleddin Soyalp,Serkan Kitis

doi:10.4236/ijcm.2016.71007

Abstract

In this study, we aimed to evaluate patients who develop ventriculostomy requirements and to evaluate the external ventricular drainage infection rates retrospectively at our clinic. In the study, dates between January 2012 and 2014, patients who were inserted external ventricular drainage with different indications were examined retrospectively. By using the medical record system, patients’ demographics (age, sex), diagnostic, ventriculostomy indications and ventriculostomy time had been reached. By accessing laboratory data, the patients’ cultures of cerebrospinal fluids biochemical tests were analyzed retrospectively. Within the period of the study, 20 in 117 patients with external ventricular drainage were not included the study because of shunt infection and shunt occlusion of extracted patients. During the treatment period 148 EVD were inserted to 97 patients. The number of male patients was 53; the number of female patients was 44. When the reason of the examined patients’ using external ventricular drainage was analyzed, 55% hemorrhagic cerebrovascular diseases, (subarachnoid hemorrhage, intraventricular hemorrhage, intracerebral hemorrhage, cerebellar hemorrhage, traumatic intracranial injury), 24.7% tumor induced use, 7.4% central nervous system infections (menengitis, apse), and 12.4% occlusive cerebrovascular diseases (hydrocephalus or brain edema that were developed after the infarct) were seen. During the course of our study, 23% of the surveyed 97 patients had leukocytosis. CFT culture of 12 patients found positive. In CFT cultures mostly coagulase-negative staphylococcus growth took place. Eventually, when we compare our infection proportions to the international literature, very large differences were not observed. Except for revisioned patients, no other criteria were found that increased the rate of infection. We think that a rigorous pre-operative preparation and a regular maintenance of external ventricular drainage may reduce the rate of infection.

Highlights

External ventricular drainage (EVD) is one of the neurosurgery methods frequently used by Brain surgeons
We aimed to evaluate patients who develop ventriculostomy requirements retrospectively and to evaluate their infection rates at our clinic for 2 years
EVDs that were inserted after the shunt removal because of shunt infection were not included in the study

Summary

Introduction

External ventricular drainage (EVD) is one of the neurosurgery methods frequently used by Brain surgeons. EVD is a surgical procedure that allows the establishment of a connection between cerebral ventricular system and external environment. EVD can be considered as a complementary venture for many neurosurgical enterprises such as intracranial hemorrhage, intracranial tumor, traumatic brain injury, cerebral edema and intracranial pressure measurement. As all surgery enterprises during and after the ventriculostomy process some complications may occur. Infection is the most important of these complications. Ventriculostomy connected infection rate is reported 0% - 22% [1] [2]. Many studies were made for the cause of infection but a common cause has not been found [3]-[8]

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