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dc.contributor.authorJamjoom, AABen
dc.contributor.authorJoannides, AJen
dc.contributor.authorPoon, MT-Cen
dc.contributor.authorChari, Aen
dc.contributor.authorZaben, Men
dc.contributor.authorAbdulla, MAHen
dc.contributor.authorRoach, Jen
dc.contributor.authorGlancz, LJen
dc.contributor.authorSolth, Aen
dc.contributor.authorDuddy, Jen
dc.contributor.authorBrennan, PMen
dc.contributor.authorBayston, Ren
dc.contributor.authorBulters, DOen
dc.contributor.authorMallucci, CLen
dc.contributor.authorJenkinson, MDen
dc.contributor.authorGray, WPen
dc.contributor.authorKandasamy, Jen
dc.contributor.authorHutchinson, PJen
dc.contributor.authorKolias, AGen
dc.contributor.authorAhmed, AIen
dc.contributor.authorBritish Neurosurgical Trainee Research Collaborativeen
dc.date.accessioned2019-11-25T21:41:46Z
dc.date.available2019-11-25T21:41:46Z
dc.date.issued2018-02en
dc.identifier.urihttp://hdl.handle.net/10026.1/15179
dc.description.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.

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dc.format.extent120 - 126en
dc.languageengen
dc.language.isoengen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAged, 80 and overen
dc.subjectCatheter-Related Infectionsen
dc.subjectCatheters, Indwellingen
dc.subjectCerebral Ventriclesen
dc.subjectChilden
dc.subjectChild, Preschoolen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectInfanten
dc.subjectInfant, Newbornen
dc.subjectIrelanden
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectNeurosurgical Proceduresen
dc.subjectPostoperative Complicationsen
dc.subjectProportional Hazards Modelsen
dc.subjectProspective Studiesen
dc.subjectStaphylococcal Infectionsen
dc.subjectUnited Kingdomen
dc.subjectVentriculostomyen
dc.subjectYoung Adulten
dc.titleProspective, multicentre study of external ventricular drainage-related infections in the UK and Ireland.en
dc.typeJournal Article
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/29070645en
plymouth.issue2en
plymouth.volume89en
plymouth.publication-statusPublisheden
plymouth.journalJ Neurol Neurosurg Psychiatryen
dc.identifier.doi10.1136/jnnp-2017-316415en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/00 Groups by role
plymouth.organisational-group/Plymouth/00 Groups by role/Professional Services staff
plymouth.organisational-group/Plymouth/Faculty of Health: Medicine, Dentistry and Human Sciences
plymouth.organisational-group/Plymouth/Faculty of Health: Medicine, Dentistry and Human Sciences/Peninsula Medical School
dc.publisher.placeEnglanden
dcterms.dateAccepted2017-10-09en
dc.identifier.eissn1468-330Xen
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1136/jnnp-2017-316415en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-02en
rioxxterms.typeJournal Article/Reviewen


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