Walek et al reported risk factors for infection of an external ventricular drain (EVD). These can help to identify a patient who should be monitored more closely. The authors are from Brown University and Rhode Island Hospital.
Patient selection: external ventricular drain
Risk factors for external ventricular drain infection:
(1) prior brain surgery associated with cerebrospinal fluid diversion (HR 8.1),which includes surgeries for prior EVD or shunt placement
(2) CSF leak around the catheter (HR 21.0)
(3) dehiscence at insertion site (HR 7.5)
Duration of drain use > 7 days had a HR of 0.62. This suggests that greater risk was in the first week after placement, which implicates the procedure.
Some predisposing risk factors included:
(1) concurrent infection
(2) failure to give or take perioperative or prophylactic antibiotics
(3) diabetes mellitus
(4) lack of strict adherence to aseptic protocol
(5) insufficient tunneling distance
(6) EVD manipulation
