วิธีปฏิบัติเพื่อลดการติดเชื้อในผู้ป่วยผ่าตัดใส่สายระบายน้ำในโพรงสมองชนิดภายนอก : ประสบการณ์จากโรงพยาบาลอุทัยธานี

Pitchayen Udom

Authors

Pitchayen Udom Uthaithani hospital

Keywords:

external ventricular drainage, external ventricular drainage infection, ventricular catheter infection Medical doctor

Abstract

Introduction : External ventricular drainage (EVD) surgery is the basic neurosurgery procedure for treating intracerebral hemorrhage (ICH) along with intraventricular hemorrhage (IVH). The main complications are infection and hydrocephalus. Best guidelines that reduce both of these complications remain the main concern for surgeons around the world

Objective : To report techniques that reduce infection in patients undergoing EVD.

Methodology : This was a retrospective cohort study conducted among the patients who had EVD in the Uthaithani Hospital between August 2020 and September 2022. A total of 64 cases were divided into two groups: those under the improved technique (case group, n=31) and the standard technique (control group, n=33). Both groups were investigated for EVD infections .

Results : There were 50.0% females in the case group and 46.4% in the control group (p-value=0.77). The mean age in the case group and the other group was 62.7±12.1 years and 62.1±13.9 years (p-value=0.85), respectively. 90.3% were diagnosed with hemorrhagic stroke in the case group and 87.9% in the control group (p-value=0.75). The mean ICH volume and IVH grading (Graeb score) were statistically insignificant (p-value=0.93 and p-value=0.73, respectively) between the groups. Likewise, the mean GCS score in the case group and the control group at admission and discharge was 9.5±3.0 vs 9.4±3.5 and 10.4± 4.2 vs 9.6±4.6, respectively. However, the average ICU stay in the case group was statistically higher (7.8±8.4 vs 14.5±11.6 days, p-value <0.01), and EVD infections were significantly lower (3.2%) than in the control group (27.3%). Regarding multiple logistic regression analysis, the infection reduction technique group was able to reduce the incidence of infection by 91%, with statistical significance (adjust oddsratio=0.09; 95% ConfidenceInterval:I 0.01-0.90; p-value 0.04).

Conclusion : The infection reduction technique in the study was effective in reducing the infection rate.

Keywords : external ventricular drainage, external ventricular drainage infection, ventricular catheter infection Medical doctor

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