MỘT SỐ YẾU TỐ LIÊN QUAN TỚI VIÊM NÃO THẤT Ở BỆNH NHÂN CHẢY MÁU NÃO THẤT ĐƯỢC ĐẶT DẪN LƯU NÃO THẤT

Abstract

Background: Ventriculitis is a serious complication in patients with intraventricular hemorrhage (IVH) requiring external ventricular drainage (EVD), yet factors associated with its development remain insufficiently characterized, particularly in resource-limited settings. Methods: We conducted a retrospective observational study of patients with IVH treated with EVD at the Emergency Center A9, Bach Mai Hospital (Hanoi, Vietnam) between January 2015 and February 2021. Clinical, laboratory, radiological, and microbiological data were collected. Ventriculitis was diagnosed based on clinical signs of infection in conjunction with cerebrospinal fluid (CSF) abnormalities or positive cultures. Multivariate logistic regression was used to identify independent risk factors. Results: Among 124 patients, the incidence of ventriculitis was 24.2%. At admission, the median Glasgow Coma Scale (GCS) score was 7 (interquartile range: 6.00–8.75), and the mean blood glucose level was 9.61 ± 2.80 mmol/L. Hospital-acquired pneumonia (HAP) occurred in 41.5% of patients. Multivariate analysis revealed that HAP was independently associated with an increased risk of ventriculitis (odds ratio [OR]: 2.641; 95% confidence interval [CI]: 1.056–6.602). Elevated blood glucose levels (≥11.10 mmol/L) also showed a trend toward association with ventriculitis (OR: 2.618; 95% CI: 0.969–7.069). Conclusion: Ventriculitis remains a common and severe complication among IVH patients receiving EVD. Hospital-acquired pneumonia is a significant independent risk factor. Strengthening infection control measures, particularly in preventing and managing HAP and optimizing glycemic control, may help reduce the burden of EVD-associated ventriculitis.