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Predictors of tract hemorrhage after external ventricular drain placement: a single-center retrospective study

Year: 2024

Type: article

Abstract: External ventricular drain (EVD) placement is often associated with complications; however, predictors of adverse outcomes after EVD placement are not well understood. This study aimed to identify predictors of EVD tract hemorrhage and to compare post-EVD hemorrhage rates between computer-assisted navigation and freehand technique EVD placement. This retrospective study included 147 consecutive patients who presented with increased intracranial pressure (ICP) requiring an EVD. Multivariable logistic regression was used to assess the relationship between predictors and adverse outcomes after EVD placement. The most common presenting pathologies in patients who had EVD placement were intraparenchymal hemorrhage (IPH) (43%) and subarachnoid hemorrhage (SAH) (28%). 14% of patients experienced EVD tract hemorrhage. Patients with platelet counts < 120 × 10³/µL (OR = 4.47, 95% CI = 1.01-20, p = 0.038), white blood cell counts < 11 × 10³/µL (OR = 3.3, 95% CI = 1.01-10.7, p = 0.048), and IPH (OR = 2.97, 95% CI = 1.06-10.7, p = 0.048) had increased risks of tract hemorrhage. The use of computer-assisted navigation did not reduce the risk of tract hemorrhage after EVD placement compared to the freehand technique. This study identified factors associated with increased risks of hemorrhage after EVD placement, which can help triage at-risk patients and reduce adverse outcomes of this procedure.

Source: Scientific Reports

DOI: 10.1038/s41598-024-79421-z

Authors: Richard Meyrat, Elaina Vivian, Bianca Dulaney, Juan Carlos Barrera Gutierrez

Institution: Methodist Dallas Medical Center

Language: English

Topic: Traumatic Brain Injury and Neurovascular Disturbances

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,590