Objectives External ventricular
drainage (EVD) is extensively used in the neurosurgical practice with the purpose of
monitoring the
intracranial pressure and draining the
cerebrospinal fluid (CSF). Despite its remarkable benefits, the
technique is not devoid of
risks, notably
infections, which have been reported in up to 45% of the cases.
Methods A retrospective
analysis of the main
risk factors for CSF
infection in neurosurgical
patients submitted to EVD at a single institution. We recorded and submitted to statistical comparison every
risk factor for CSF
infection present or absent in each of the 110 EVD
patients enrolled, 53
males and 57
females, with an average age of 52.9 years, with different underlying neurosurgical conditions. Results
Infection of the CSF occurred in 32
patients (29%). The rate of
mortality related to CSF
infection was of 18.7% (6 of 32). The
risk factors that showed statistical significance for CSF
infection in this series were
emergency surgery;
length of stay at the
intensive care unit (UCI); duration of the EVD; parenchymal and/or intraventricular
hemorrhage; simultaneous
infections;
time of
bladder catheterization; and the use of non-disposable
adhesive drapes as part of the preparation of the
wound area. Conclusions
Infection of the CSF in
patients submitted to EVD is multifactorial and a challenge in terms of prevention. Further studies proposing scores with blended
risk factors may be useful to prevent and reduce the
morbidity and
mortality associated with CSF
infection.