Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland. Issue 2 (25th October 2017)

• Record Type: Journal Article
• Authors: Jamjoom, Aimun A B; Joannides, Alexis J; Poon, Michael Tin-Chung; Chari, Aswin; Zaben, Malik; Abdulla, Mutwakil A H; Roach, Joy; Glancz, Laurence J; Solth, Anna; Duddy, John; Brennan, Paul M; Bayston, Roger; Bulters, Diederik O; Mallucci, Conor L; Jenkinson, Michael D; Gray, William P; Kandasamy, Jothy; Hutchinson, Peter J; Kolias, Angelos G; Ahmed, Aminul I
• Other Names: author non-byline.; Alalade A author non-byline.; Bailey M author non-byline.; Basu S author non-byline.; Baudracco I author non-byline.; Bhattacharya A author non-byline.; Bodkin Pa author non-byline.; Boissaud-cooke M author non-byline.; Bojanic S author non-byline.; Buxton N author non-byline.; Corns R author non-byline.; Coulter C author non-byline.; Coulter I author non-byline.; Critchley G author non-byline.; Dando A author non-byline.; Dardis R author non-byline.; Dyson E author non-byline.; Edwards R author non-byline.; Garnett M author non-byline.; Gatcher S author non-byline.; Georges H author non-byline.; Hallet J author non-byline.; Harte J author non-byline.; Haylock-vize P author non-byline.; Humphreys H author non-byline.; Kitchen J author non-byline.; Lawson Mclean A author non-byline.; Loan JJM author non-byline.; Ma R author non-byline.; Madder H author non-byline.; Manning A author non-byline.; Mcelligott S author non-byline.; Mukerji N author non-byline.; Narayanamurthy H author non-byline.; O'brien D author non-byline.; Okasha M author non-byline.; Papadopoulos M author non-byline.; Phan V author non-byline.; Phang I author non-byline.; Poots J author non-byline.; Rajaraman C author non-byline.; Ross N author non-byline.; Sharouf F author non-byline.; Shastin D author non-byline.; Simms N author non-byline.; Steele L author non-byline.; Tajsic T author non-byline.; Talibi S author non-byline.; Thanabalasundaram G author non-byline.; Vintu M author non-byline.; Wan Y author non-byline.; Wang D author non-byline.; Watkins L author non-byline.; Whitehouse K author non-byline.; Whitfield PC author non-byline.; Williams A author non-byline.;
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 89:Issue 2(2018)
• Page Start: 120
• Page End: 126
• Publication Date: 2017-10-25
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2017-316415
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objectives: External ventricular drain (EVD) insertion is a common neurosurgical procedure. EVD-related infection (ERI) is a major complication that can lead to morbidity and mortality. In this study, we aimed to establish a national ERI rate in the UK and Ireland and determine key factors influencing the infection risk. Methods: A prospective multicentre cohort study of EVD insertions in 21 neurosurgical units was performed over 6 months. The primary outcome measure was 30-day ERI. A Cox regression model was used for multivariate analysis to calculate HR. Results: A total of 495 EVD catheters were inserted into 452 patients with EVDs remaining in situ for 4700 days (median 8 days; IQR 4–13). Of the catheters inserted, 188 (38%) were antibiotic-impregnated, 161 (32.5%) were plain and 146 (29.5%) were silver-bearing. A total of 46 ERIs occurred giving an infection risk of 9.3%. Cox regression analysis demonstrated that factors independently associated with increased infection risk included duration of EVD placement for ≥8 days (HR=2.47 (1.12–5.45); p=0.03), regular sampling (daily sampling (HR=4.73 (1.28–17.42), p=0.02) and alternate day sampling (HR=5.28 (2.25–12.38); p<0.01). There was no association between catheter type or tunnelling distance and ERI. Conclusions: In the UK and Ireland, the ERI rate was 9.3% during the study period. The study demonstrated that EVDs left in situ for ≥8 days and those sampled more frequently were associated with a higher risk of infection. Importantly, the study showed no significant difference in ERI risk between different catheter types.