External Ventricular Drain Infections: Risk Factors and Outcome

External ventricular drainage (EVD) is frequently used in neurosurgery to drain cerebrospinal fluid in patients with raised intracranial pressure. We performed a retrospective single center study in order to evaluate the incidence of EVD-related infections and to identify underlying risk factors. 24...

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Main Authors: S. Hagel, T. Bruns, M. W. Pletz, C. Engel, R. Kalff, C. Ewald
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Interdisciplinary Perspectives on Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2014/708531
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author S. Hagel
T. Bruns
M. W. Pletz
C. Engel
R. Kalff
C. Ewald
author_facet S. Hagel
T. Bruns
M. W. Pletz
C. Engel
R. Kalff
C. Ewald
author_sort S. Hagel
collection DOAJ
description External ventricular drainage (EVD) is frequently used in neurosurgery to drain cerebrospinal fluid in patients with raised intracranial pressure. We performed a retrospective single center study in order to evaluate the incidence of EVD-related infections and to identify underlying risk factors. 246 EVDs were placed in 218 patients over a 30-month period. EVD was continued in median for 7 days (range 1–44). The cumulative incidence of EVD-related infections was 8.3% (95% CI, 5.3–12.7) with a device-associated infection rate of 10.4 per 1000 drainage days (95% CI, 6.2–16.5). The pathogens most commonly identified were coagulase-negative Staphylococcus (62%) followed by Enterococcus spp. (19%). Patients with an EVD-related infection had a significantly longer ICU (11 versus 21 days, P<0.01) and hospital stay (20 versus 28.5 days, P<0.01) than patients without. Median total duration of external drainage was twice as long in patients with EVD-related infection (6 versus 12 days, P<0.01). However, there was no significant difference in the duration between first EVD placement and the occurrence of EVD-related infection and EVD removal in patients without EVD-related infection (6 versus 7 days, P=0.87), respectively. Interestingly no risk factor for EVD-related infection could be identified in our cohort of patients.
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spelling doaj-art-6608effa7a044674b5f0632b10eebf2d2025-08-20T02:23:48ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982014-01-01201410.1155/2014/708531708531External Ventricular Drain Infections: Risk Factors and OutcomeS. Hagel0T. Bruns1M. W. Pletz2C. Engel3R. Kalff4C. Ewald5Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, GermanyCenter for Sepsis Control & Care (CSCC), Jena University Hospital, Jena, GermanyCenter for Infectious Diseases and Infection Control, Jena University Hospital, Jena, GermanyInstitute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, GermanyDepartment of Neurosurgery, Jena University Hospital, Jena, GermanyDepartment of Neurosurgery, Jena University Hospital, Jena, GermanyExternal ventricular drainage (EVD) is frequently used in neurosurgery to drain cerebrospinal fluid in patients with raised intracranial pressure. We performed a retrospective single center study in order to evaluate the incidence of EVD-related infections and to identify underlying risk factors. 246 EVDs were placed in 218 patients over a 30-month period. EVD was continued in median for 7 days (range 1–44). The cumulative incidence of EVD-related infections was 8.3% (95% CI, 5.3–12.7) with a device-associated infection rate of 10.4 per 1000 drainage days (95% CI, 6.2–16.5). The pathogens most commonly identified were coagulase-negative Staphylococcus (62%) followed by Enterococcus spp. (19%). Patients with an EVD-related infection had a significantly longer ICU (11 versus 21 days, P<0.01) and hospital stay (20 versus 28.5 days, P<0.01) than patients without. Median total duration of external drainage was twice as long in patients with EVD-related infection (6 versus 12 days, P<0.01). However, there was no significant difference in the duration between first EVD placement and the occurrence of EVD-related infection and EVD removal in patients without EVD-related infection (6 versus 7 days, P=0.87), respectively. Interestingly no risk factor for EVD-related infection could be identified in our cohort of patients.http://dx.doi.org/10.1155/2014/708531
spellingShingle S. Hagel
T. Bruns
M. W. Pletz
C. Engel
R. Kalff
C. Ewald
External Ventricular Drain Infections: Risk Factors and Outcome
Interdisciplinary Perspectives on Infectious Diseases
title External Ventricular Drain Infections: Risk Factors and Outcome
title_full External Ventricular Drain Infections: Risk Factors and Outcome
title_fullStr External Ventricular Drain Infections: Risk Factors and Outcome
title_full_unstemmed External Ventricular Drain Infections: Risk Factors and Outcome
title_short External Ventricular Drain Infections: Risk Factors and Outcome
title_sort external ventricular drain infections risk factors and outcome
url http://dx.doi.org/10.1155/2014/708531
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AT mwpletz externalventriculardraininfectionsriskfactorsandoutcome
AT cengel externalventriculardraininfectionsriskfactorsandoutcome
AT rkalff externalventriculardraininfectionsriskfactorsandoutcome
AT cewald externalventriculardraininfectionsriskfactorsandoutcome