RESUMO
External ventricular drains (EVDs), like any surgically-implanted foreign body, are at risk of infection. We present the results of a completed audit loop following introduction of an evidence-based protocol for their insertion and management. There were two phases over a 2-year period. Phase 1 was a retrospective audit of our EVD infection rate. Phase 2 was a prospective audit of the infection rate subsequent to the introduction of a protocol for the insertion and management of EVDs. In phase 1, the infection rate was 27%. In phase 2, the infection rate was 12%. This was a statistically significant reduction (p < 0.05, Chi-squared test). EVD infection is unfortunately a common clinical problem and associated with potential morbidity and mortality. This study demonstrates that adherence to an evidence-based protocol for their insertion and management is associated with a significant reduction in the infection rate.
Assuntos
Cateteres de Demora/efeitos adversos , Infecções Bacterianas do Sistema Nervoso Central/prevenção & controle , Protocolos Clínicos/normas , Drenagem/normas , Infecções Bacterianas do Sistema Nervoso Central/etiologia , Ventrículos Cerebrais/cirurgia , Derivações do Líquido Cefalorraquidiano/efeitos adversos , Drenagem/efeitos adversos , Encefalite/etiologia , Encefalite/prevenção & controle , Medicina Baseada em Evidências/normas , Feminino , Humanos , Pressão Intracraniana , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/efeitos adversos , Estudos Prospectivos , Estudos RetrospectivosRESUMO
OBJECT: The purpose of this study was to evaluate the relationship between atmospheric pressure and subarachnoid hemorrhage (SAH) in a region in the English Midlands. METHODS: All patients with angiographically proven SAH for the calendar year 1998 were analyzed. A geographical allocation was made based on the patients' origin within the region. The events were then compared with the data available for the local atmospheric pressures. One hundred nine patients had an SAH during the time period studied. The median atmospheric pressure recorded was 1014.5 millibars. Atmospheric pressure was modestly correlated with the number of SAHs per day (Spearman's rank correlation, r = 0.33; p < 0.0001); the daily change in atmospheric pressure also correlated mildly (r = 0.34, p < 0.0001). No other statistically significant association was found. CONCLUSIONS: The authors have shown a relationship between high atmospheric pressure and increased incidence of SAH. The underlying reason for this remains obscure.
