Risk of Infection with Prolonged Ventricular Catheterization
| Autor: | B. Gregory Thompson, Hugh J. L. Garton, Mary Jo Kocan, Paul Park |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Ventriculostomy medicine.medical_specialty Adolescent Critical Care medicine.medical_treatment Risk Assessment Catheters Indwelling medicine Humans Life Tables Risk factor Aged Cerebrospinal Fluid Monitoring Physiologic Proportional Hazards Models Aged 80 and over Cross Infection Catheter insertion Cerebrospinal fluid leak business.industry Proportional hazards model Risk of infection Bacterial Infections Length of Stay Middle Aged medicine.disease Surgery Catheter Equipment Failure Female Neurology (clinical) Intracranial Hypertension business Risk assessment |
| Zdroj: | Neurosurgery. 55:594-601 |
| ISSN: | 0148-396X |
| DOI: | 10.1227/01.neu.0000134289.04500.ee |
| Popis: | Objective The relationship between extended ventricular catheterization and infection remains controversial. Although studies have substantiated an increasing infection rate with prolonged catheterization, there has been less agreement on whether this trend continues beyond 10 days. Our study reviews the daily infection rate of 595 patients, 213 of whom underwent more than 10 days of catheterization. Methods All patients who underwent ventricular monitoring in the neurological intensive care unit from 1995 to 2003 at the University of Michigan Health System were reviewed retrospectively. Infection was defined as a positive cerebrospinal fluid culture. Life-table analysis was used to calculate daily hazard (infection) rates. Patient age, sex, diagnosis, catheter exchanges, location of patient during catheter insertion, and cerebrospinal fluid leak were evaluated as risk factors for infection. Results The average patient age was 51.3 years, and 51.3% were male. Duration of catheterization averaged 8.6 days. The overall infection rate was 8.6%. Daily infection rates increased from the onset of catheter insertion but reached a plateau after Day 4, with subsequent rates ranging predominantly between 1 and 2%, even with extended catheterization beyond 10 days. Only ventricular catheters that had been placed at other institutions significantly affected the infection rate. Conclusion A relationship between duration of catheterization and infection seems to be present. However, this relationship is not linear. There is an extremely low daily infection rate that rises over the initial 4 days but then remains relatively constant even with prolonged catheter use. Clinical decisions to continue ventricular catheterization should reflect this low daily risk of infection, which does not seem to increase with extended catheter use. |
| Databáze: | OpenAIRE |
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