Drenaje ventricular al exterior de tunelización larga: un método costo-efectivo para reducir las complicaciones

Premio Beca Asociación Argentina de Neurocirugía. XV Jornadas Argentinas de Neurocirugía 2019

Abstract

Introduction: External ventricular drain (EVD) placement is one of the most frequent procedures in neurosurgery, both in pediatrics and in adults. The global rate of ventriculostomy-associated infections could rich 25%. In our Hospital, we found an annual incidence of 22%.
In addition, since it does not have a regulation of cerebral spinal fluid (CSF) flow, the patient must remain in strict dorsal decubitus throughout the entire treatment.
Our goal is to design a new long-tunneled external ventricular drain (LTEVD) that deals with these problems while reducing hospital costs.
Material and method: A prospective clinical trial was conducted in which 25 LTEVD were placed between 1/9/2018 and 1/5/2019 that were compared with the traditional EVD system.
Results: The presence of CSF fistula was associated more frequently with EVD compared to LTEVD; this difference was statistically significant (30% vs. 8% p = 0.029). The presence of associated infection was significantly higher in EVD compared to LTEVD, and this difference was statistically significant (22% vs. 0% p = 0.009). Patients with traditional EVD used twice as many resources and generated twice the cost as patients with DVETL.
Conclusion: A detailed presentation was made of the new LTEVD system that presents a decrease in the incidence of CSF fistula and associated infection. At the same time, it appears to be cost-effective in comparison with the traditional DVE system.