ArticleNeurocritical care2026
Impact of Hemorrhage Extent on External Ventricular Drain-Associated Infections in Aneurysmal Subarachnoid Hemorrhage.
Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pressure-controlled active CSF irrigation versus non-pressure-controlled management following aneurysmal subarachnoid hemorrhage: a systematic review and comparative meta-analysis of DCI and safety outcomes.Neurosurgical review · 2026Pooled it
- Incidence and patient-related risk factors for external ventricular drain-related cerebrospinal fluid infections.Brain & spine · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExternal ventricular drain (EVD)-associated infections (EVDAI) remain a relevant complication of acute hydrocephalus treatment following aneurysmal subarachnoid hemorrhage (aSAH). Whether radiological quantity and anatomical distribution of subarachnoid and ventricular blood impact EVDAI rates has not been thoroughly studied to date.
methodsThis was a retrospective (2009-2023) analysis of patients with aSAH undergoing emergency ventriculostomy. Univariable and multivariable logistic regression analyses were used to assess the association between the Barrow Neurological Institute (BNI) grading scale for subarachnoid hemorrhage and the intraventricular hemorrhage (IVH) score for extent and anatomical distribution of intracerebral bleeding with EVDAI risk. Cox regression analysis was employed to investigate the relationship between hemorrhage extent and the timing of EVDAI onset.
resultsOne hundred and ninety-four patients with aSAH received 228 EVDs with a total of cumulative 2,258 EVD days. Overall EVDAI rates were 14% (27/194) per patient and 12% (27/228) per EVD. EVDAI was associated with a larger subarachnoid blood clot (BNI grade 4; odds ratio 6.66, 95% confidence interval 2.04-21.68; p = 0.002) and higher IVH scores (odds ratio 1.33, 95% confidence interval 1.05-1.69; p = 0.02). Intracerebral hemorrhage was more frequently localized in the posterior fossa in the EVDAI group (20% vs. 0%, p = 0.004). Multivariable analysis confirmed a positive independent correlation with larger blood clots. Cox regression demonstrated earlier EVDAI onset in association with higher BNI grades and IVH scores.
conclusionsBoth the quantity and radiological distribution of subarachnoid and ventricular blood positively correlate with EVD-associated nosocomial meningitis, eventually accelerating an earlier infection onset. These findings should help guide future research on EVDAI prevention in patients with aSAH.
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