Evidence map›Paper›PMID 41853587›Full record

ArticleBrain & spine2026

Incidence and patient-related risk factors for external ventricular drain-related cerebrospinal fluid infections.

Aron Alakmeh, Mergime Maralushaj, Vittorio Stumpo, Daniel de Wilde, Erik Edström, Adrian Elmi Terander, Stefanos Voglis, Flavio Vasella, Luca Regli, Carlo Serra and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Brain & spine, 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.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Routine versus clinically indicated cerebrospinal fluid sampling for infection in external ventricular drains: a systematic review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Aron AlakmehMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Mergime MaralushajNeurosurgical Intensive Care Unit, Institute of Intensive Care Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Vittorio StumpoMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Daniel de WildeMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Erik EdströmDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Adrian Elmi TeranderDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Stefanos VoglisMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Flavio VasellaMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Luca RegliMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Carlo SerraMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Giovanna BrandiNeurosurgical Intensive Care Unit, Institute of Intensive Care Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Victor E StaartjesMachine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Despite procedural standardization, external ventricular drain-related infections (EVD-RI) remain frequent, with reported incidences of 5-30%. The underlying risk factors, however, remain insufficiently understood and have been debated for decades. Research question: To address this, patient-related and periprocedural risk factors for EVD-RI in adults undergoing EVD placement were analyzed. Materials and methods: This single-center cohort included adults receiving EVD implantation between 2014 and 2022. Suspected EVD-RI was defined according to Infectious Diseases Society of America (IDSA). Confirmed EVD-RI required a positive CSF culture and/or broad-range eubacterial PCR. The primary outcome was suspected EVD-RI. Patient-related factors were assessed for their role as independent predictors or confounders using a multivariable Cox proportional hazards model with purposeful variable selection. Results: A total of 387 patients with 421 EVDs were included. Suspected EVD-RI occurred in 104 (26.9%) patients and confirmed EVD-RI in 63 (16.3%) patients. EVD exchange (HR: 3.13, 95% CI: 2.02-4.85, Discussion and conclusion: EVD-RI risk is driven primarily by periprocedural rather than patient-related factors. Avoiding EVD exchanges, preventing leaks/obstruction, minimizing drainage duration, and early definitive diversion may reduce infections.

Indexed as

Cerebrospinal fluidExternal ventricular drainIncidenceInfectionRisk factorsVentriculostomy

Identifiers

PMID41853587
PMCPMC12992071

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.