Gu Chenghao, Lind Allice N R, Haldrup Mette, Eschen Jens T, Eskildsen Mads H, Kjær Asbjørn, Rasmussen Mads, Dyrskog Stig, Meier Kaare, Simonsen Claus Z, Debrabant Birgit, Korshøj Anders R
Departments of1Neurosurgery.
2Department of Clinical Medicine, Aarhus University, Aarhus.
J Neurosurg. 2025 Jan 3;142(6):1599-1605. doi: 10.3171/2024.8.JNS24915. Print 2025 Jun 1.
Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs.
The authors conducted a retrospective observational study using the Danish National Patient Registry. Patients treated with EVDs for pIVH or secondary IVH between September 2012 and August 2022 at Aarhus University Hospital were included. Demographic data, clinical treatment, and outcomes were extracted and analyzed.
A total of 436 patients with 615 EVDs were included. Of these, 4.1% had pIVH, 60.6% had IVH secondary to subarachnoid hemorrhage, and 35.3% had IVH secondary to intracerebral hemorrhage. During EVD treatment, 38.8% of patients experienced complications, including complete occlusion (17.2%), partial occlusion (16.1%), ventriculitis (7.1%), and other complications (9.6%). Of patients surviving the initial 30 days, 34.2% received a ventriculoperitoneal shunt, and 29.9% remained shunt dependent 6 months after inclusion. Mortality rates were 28.9% at 30 days and 33.7% at 90 days. A total of 31.0% of patients had good functional outcomes at 90 days.
This study provides a comprehensive historical reference of complications, mortality rate, and functional outcome of EVD-treated patients with pIVH and secondary IVH. These findings provide a baseline for evaluating novel catheter-based interventions in IVH management.
脑室内出血（IVH）是一种严重疾病，死亡率高，幸存者功能预后差。治疗方法包括外置脑室引流管（EVD），但该方法会引发多种并发症。本研究报告了接受EVD治疗的原发性IVH（pIVH）和继发性IVH患者的临床结局及并发症发生率。
作者利用丹麦国家患者登记系统进行了一项回顾性观察研究。纳入2012年9月至2022年8月在奥胡斯大学医院接受EVD治疗的pIVH或继发性IVH患者。提取并分析人口统计学数据、临床治疗情况及结局。
共纳入436例患者，置入615根EVD。其中，4.1%为pIVH，60.6%为蛛网膜下腔出血继发IVH，35.3%为脑出血继发IVH。在EVD治疗期间，38.8%的患者出现并发症，包括完全堵塞（17.2%）、部分堵塞（16.1%）、脑室炎（7.1%）及其他并发症（9.6%）。在最初30天存活的患者中，34.2%接受了脑室腹腔分流术，纳入后6个月时，29.9%仍依赖分流。30天死亡率为28.9%，90天死亡率为33.7%。90天时，共有31.0%的患者功能预后良好。
本研究提供了接受EVD治疗的pIVH和继发性IVH患者并发症、死亡率及功能结局的全面历史参考。这些发现为评估IVH管理中基于导管的新型干预措施提供了基线。
