Outcomes Associated with Emergent Insertion of External Ventricular Drains in Patients without Prior Neurosurgical History
- Author:
Nassim STEGAMAT
1
;
Stephen JAFFEE
;
Shahed ELHAMDANI
;
Jenna LI
;
Jody LEONARDO
;
Alexander YU
Author Information
- Publication Type:Original Article
- From: Journal of Neurointensive Care 2025;8(2):47-51
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:External ventricular drain (EVD) placement is one of the most commonly used interventions in life-saving neurosurgical care. EVDs are often used to treat traumatic brain injuries, infection, primary and secondary hydrocephalus, and intracranial space occupying lesions, such as tumors, cysts, and ischemic/hemorrhagic strokes. EVDs have been proven to reduce mortality but are often associated with complications that can affect patient outcomes. Our study investigates the patient outcomes associated with emergent EVD placement in a patient population with no prior history of neurosurgery.
Methods:A retrospective chart review was performed on all patients 18+ requiring emergent EVD placement from January 2016 to December 2022 at Allegheny General Hospital in Pittsburgh, PA. Exclusion criteria included intra-operative EVD placements and patients with any prior neurosurgical history. 223 patient charts were analyzed for outcomes of independent ambulation capability, length of hospital stay, subsequent neurosurgical intervention, and final patient disposition. Subsequent neurosurgical interventions were stratified into six subcategories: EVD removal only, subsequent EVD placement, ventriculoperitoneal shunt (VPS) placement, endoscopic third ventriculostomy (ETV), craniotomy, and other. Patient disposition included home, inpatient rehab, skilled nursing facility, long-term acute care, hospice, and expiration.
Results:Our study demonstrated that only 10% of patients were able to ambulate independently at discharge, 24% of patients required shunt placement, 20% of patients expired in hospital and the average length of hospital stay was 20 days.
Conclusions:Despite there being immense research demonstrating the efficacy and safety of EVDs, there is limited literature for clinicians and patients together to demonstrate the clinical gravity of EVD placement. Our study accurately delineates the clinical patient outcomes associated with EVD placement on neuro-surgically naive patients.
