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68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

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Prospective multi-centre study of external ventricular drainage management and infection rate in the United Kingdom and Ireland

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  • Aimun Jamjoom - Western General Hospital & University of Edinburgh, Department of Clinical Neurosciences, Division of Neurosurgery, Edinburgh, United Kingdom
  • Alexis Joannides - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Michael Poon - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Aswin Chari - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Angelos Kolias - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • John Kitchen - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Malik Zaben - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Paul Brennan - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Peter Hutchinson - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom
  • Aminul I. Ahmed - The British Neurosurgical Trainee Research Collaborative, Edinburgh, United Kingdom

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.15.04

doi: 10.3205/17dgnc262, urn:nbn:de:0183-17dgnc2626

Veröffentlicht: 9. Juni 2017

© 2017 Jamjoom et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives: To establish contemporary practice patterns and the infection rate of External Ventricular Drainage (EVD) in the UK and Ireland.

Methods: Clinical variables were prospectively collected over a 6-month period on patients who have an EVD inserted in 21 participating units. The primary outcome measure was 30-day EVD-related infection (ERI). A Cox Regression Model was used for multivariate analysis.

Results: A total of 495 EVD catheters were inserted into 357 patients equating to 4626 drainage days. Neurovascular (65%) was the most common aetiology for EVD insertion followed by tumours (18%) and trauma (7%). Of the catheters, 188 (38%) were antibiotic-impregnated, 161 (32%) were non-impregnated and 146 (30%) were silver-impregnated catheters. A total of 45 ERIs occurred giving the cohort an infection rate of 9%. Multivariate analysis adjusted for age and sex showed that EVD duration of ³8 days had a significantly higher risk of ERI [HR=2.47(1.12-5.45); p=0.02] compared to catheters in-situ <8 days. There was no significant difference in ERI risk between the different catheter types in the multivariate analysis.

Conclusions: In the UK, EVD infection rate was 9% during the study period. The audit demonstrated wide variation in the choice of catheter type across the country with no significant difference in ERI rate between them. Importantly, it also highlighted that EVDs left in situ for ³8 days have a higher risk of infection.