المؤلفون: Jamjoom, Aimun AB, Joannides, Alexis J, Poon, Michael Tin-Chung, Chari, Aswin, Zaben, Malik, Abdulla, Mutwakil AH, 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, British Neurosurgical Trainee Research Collaborative

مصطلحات موضوعية: Adolescent, Adult, Aged, 80 and over, Catheter-Related Infections, Catheters, Indwelling, Cerebral Ventricles, Child, Preschool, Female, Humans, Infant, Newborn, Ireland, Male, Middle Aged, Neurosurgical Procedures, Postoperative Complications, Proportional Hazards Models, Prospective Studies, Staphylococcal Infections, United Kingdom, Ventriculostomy, Young Adult

الوصف: 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.

وصف الملف: Print-Electronic; application/pdf

العلاقة: https://www.repository.cam.ac.uk/handle/1810/270951Test

الإتاحة: https://doi.org/10.17863/CAM.17897Test
https://www.repository.cam.ac.uk/handle/1810/270951Test

المؤلفون: Jamjoom, Aimun AB, Joannides, Alexis J, Poon, Michael Tin-Chung, Chari, Aswin, Zaben, Malik, Abdulla, Mutwakil AH, 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, British Neurosurgical Trainee Research Collaborative

مصطلحات موضوعية: Adult, Aged, 80 and over, Male, Adolescent, Infant, Newborn, Infant, Middle Aged, Staphylococcal Infections, Neurosurgical Procedures, United Kingdom, 3. Good health, Cerebral Ventricles, Ventriculostomy, Young Adult, Catheters, Indwelling, Postoperative Complications, Catheter-Related Infections, Child, Preschool, Humans, Female, Prospective Studies, Child, Ireland, Aged, Proportional Hazards Models

الوصف: 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

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::925a2e85db32cbf25714785fcd824cc8Test