Infecção liquórica em drenagem ventricular externa: avaliação dos fatores de risco em 110 pacientes de uma única instituição

• Published in: Arquivos brasileiros de neurocirurgia Vol. 39; no. 3; pp. 161 - 169
• Main Authors: Larsen, Itamar Cristian, Matias, Jorge Eduardo F., Moro, Marlus S., Maranha, Luana A., Araújo, João Cândido
• Format: Journal Article
• Language: English
• Published: Rio de Janeiro, Brazil Thieme Revinter Publicações Ltda 01-09-2020
• Subjects: cerebrospinal fluid infection; external ventricular drainage; Original Article | Artigo Original; risk factors; derivação ventricular externa; risk factors; cerebrospinal fluid infection; external ventricular drainage; infecção liquórica; fatores de risco
• ISSN: 0103-5355; 2359-5922
• DOI: 10.1055/s-0040-1713917

Abstract
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.