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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Significance of CSF markers for detection of ventriculitis in patients with EVD after traumatic brain injury

Ventrikulitis bei externer Ventrikeldrainage nach Schädel-Hirn-Trauma – retrospektive Analyse zur prognostischen Wertigkeit von Biomarkern in Serum und Liquor

Meeting Abstract

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  • presenting/speaker Markus Lenski - Klinikum der Ludwig-Maximilians-Universität, Neurochirurgie, München, Deutschland
  • Annamaria Biczok - Klinikum der Ludwig-Maximilians-Universität, Neurochirurgie, München, Deutschland
  • Christian Schichor - Klinikum der Ludwig-Maximilians-Universität, Neurochirurgie, München, Deutschland
  • Josef Briegel - LMU München, München, Deutschland
  • Jörg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität, Neurochirurgie, München, Deutschland
  • Niklas Thon - Klinikum der Ludwig-Maximilians-Universität, Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV055

doi: 10.3205/19dgnc070, urn:nbn:de:0183-19dgnc0704

Veröffentlicht: 8. Mai 2019

© 2019 Lenski 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

Objective: The aim of this study was to investigate in patients with traumatic brain injury and external ventricular drain the diagnostic potential of inflammatory markers in cerebro-spinal fluid (CSF) and serum (S) (CSF_IL-6, CSF_total leucocyte count, CSF_protein, S_CRP, S_white blood cell count) for the early diagnosis of ventriculitis (VC_TBI) compared to patients without ventriculitis (TBIw/o/v).

Methods: Retrospective data from 40 consecutive patients with traumatic brain injury (TBI) and external ventricular drainage (EVD) were analysed. For all markers arithmetical means and standard deviations, area under the curve (AUC), cutoff values (C-OFF), sensitivity (SE), specificity (SP), positive (+LR) and negative Likelihood-Ratio (-LR) were calculated and correlated with VC_TBI and TBIw/o/v.

Results: Clinical courses included 35 patients with TBIw/o/v and 5 patients with VC_TBI. Mean ± standard deviation of CSF_IL-6 values were 6519±4268 pg/ml at onset of VCTBI as compared to 1065±1705 pg/ml without (p=0.04). CSF_IL-6 showed excellent diagnostic potential for differing between VC_TBI and TBIw/o/v (AUC=0.938, C-OFF=4064 pg/ml, SE=100%, SP=92.3%, +LR= 13, -LR=0), followed by CSF_ total leucocyte count (AUC=0.900, C-OFF=65 /µL, SE= 100%, SP=80, +LR=5.0, -LR=0) and CSF_protein (AUC=0.875, C-OFF=32 mg/dl, SE=100%, SP=63%, +LR=2.7, -LR=0).

Conclusion: CSF_IL-6 is significantly increased in patients with ventriculitis after TBI. Patients with a CSF_IL-6 level higher than the threshold of 4064 pg/ml have a significantly increased posttest probability for VC_TBI. Therefore CSF_IL-6 is a useful early marker for diagnosing ventriculitis in TBI patients.

Figure 1 [Fig. 1]