Abstract Details

Title Association of External Ventricular Drain Duration and Cerebral Infarct in Aneurysmal Subarachnoid Hemorrhage

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-017

Objective

To determine the association of EVD duration with outcomes, including cerebral infarct.

Background The optimal duration of external ventricular drain (EVD) in patients with aneurysmal subarachnoid hemorrhage (aSAH) is debatable. We sought to determine the association of EVD duration with outcomes, including cerebral infarct.

Design/Methods We performed a retrospective study of a prospectively collected cohort of consecutive patients with aSAH who were admitted to an academic center from 2016 to 2023. Multivariate logistic regression was used to determine the association of EVD duration with outcomes, including cerebral infarct prior to discharge (excluding immediate post aneurysm securement infarcts) and a shift in 3-month modified Rankin Scale (mRS). Hospital mortalities were excluded in functional outcome ordinal shift analysis.

Results We reviewed 429 cases of aSAH and included 306 patients who received EVD with mean age 57.9 years (SD 13.9), 67% female and 69% white. EVD duration was longer in patients with cerebral infarcts compared to those without infarcts (mean 15.8 days [SD 13.7] vs 13 [11.8]; p=0.016). Longer EVD duration was associated with higher odds of cerebral infarct (OR 1.04 for each day increase, 95% CI 1.01-1.07; p=0.003) independent of age, sex, Hunt and Hess grade, modified Fisher score and aneurysm securement mode. However, EVD duration was not associated with worse functional outcome (OR 1.02, 95% CI 0.98-1.06; p=0.23) when adjusted for other predictors.

Conclusions Longer EVD duration may not improve functional outcome and can be associated with more cerebral infarcts in patients with aSAH. Unnecessary prolongation of EVD duration should be discouraged. Larger prospective studies are needed to confirm these findings.

Authors/Disclosures
Ariyaporn Haripottawekul PRESENTER	Miss Haripottawekul has nothing to disclose.
Roya Barakzai	Miss Barakzai has received personal compensation for serving as an employee of New York City Department of Health and Mental Hygiene . Miss Barakzai has received personal compensation for serving as an employee of LI Urgent Care.
Wendy Gonzalez	Ms. Gonzalez has nothing to disclose.
Elijah M. Persad-Paisley	Mr. Persad-Paisley has nothing to disclose.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ)	The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Ali Mahta, MD (Brown University)	Dr. Mahta has received research support from Brown University Health.

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