Associations between Features of External Ventricular Drain Management, Disposition, and Shunt Dependence


<jats:title>Abstract</jats:title><jats:p> Background In the United States, nearly 25,000 patients annually undergo percutaneous ventriculostomy for the management of increased intracranial pressure with little consensus on extraventricular drain management. To characterize relationships between external ventricular drain management, permanent ventriculoperitoneal shunt placement, and hospital disposition, we hypothesized that patients requiring extended drainage would have greater association with ventriculoperitoneal shunt placement and unfavorable disposition.</jats:p><jats:p> Methods Adult patients admitted to the Duke University Hospital Neuroscience Intensive Care Unit between 2008 and 2010 with extraventricular drains were analyzed. A total of 115 patient encounters were assessed to determine relative impact of age, sex, days of extraventricular placement, weaning attempts, cerebrospinal fluid drainage volumes, Glasgow Coma Scale, and physician’s experience on disposition at discharge and ventriculoperitoneal shunt placement. Univariate logistic regression was first used to test the effect of each variable on the outcome, followed by backward selection to determine a final multivariable logistic regression. Variables in the final model meeting p < 0.05 were declared as significant factors for the outcome.</jats:p><jats:p> Results Increased extraventricular drain duration (odds ratio [OR] = 1.17, confidence interval [CI] = 1.05–1.30, p = 0.0049) was associated with ventriculoperitoneal shunt placement, while older age (OR = 1.05, CI = 1.02–1.08, p = 0.0027) and less physician extraventricular drain management experience (OR = 4.04, CI = 1.67–9.79, p = 0.0020) were associated with unfavorable disposition.</jats:p><jats:p> Conclusion In a small cohort, exploratory analyses demonstrate potentially modifiable factors are associated with important clinical outcomes. These findings warrant further study to refine how such factors affect patient outcomes.</jats:p>






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Publication Info

Engel, C, AL Faulkner, DW Van Wyck, AR Zomorodi, NKK King, RA Williamson Taylor, CE Hailey, OA Umeano, et al. (n.d.). Associations between Features of External Ventricular Drain Management, Disposition, and Shunt Dependence. Journal of Neuroanaesthesiology and Critical Care. 10.1055/s-0040-1710410 Retrieved from

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Amanda Faulkner

Assistant Professor of Anesthesiology
Van Wyck

David Wayne Van Wyck

Assistant Consulting Professor in the Department of Neurology

Ali Reza Zomorodi

Professor of Neurosurgery

Yi-Ju Li

Professor of Biostatistics & Bioinformatics

My research interest is in statistical genetics, including statistical method development and its application for understanding the genetic predisposition of human complex diseases. Here is the list of research topics:

  • Statistical genetics: development of family-based association methods for quantitative traits with or without censoring and for detecting X-linked genes for disease risk.  With the availability of next generation sequencing data, we have ongoing projects to develop the association methods for testing rare variants for different phenotypic measures.  
  • Genetics of Alzheimer's disease (AD) and Fuchs endothelial corneal dystrophy (FECD).
  • Genetic basis of age-at-onset of Alzheimer disease. 
  • Peri-operative genomic studies. Investigate the genetic risk factors for postoperative outcomes of patients underwent non-emergent coronary artery bypass grafting with cardiopulmonary bypass.

Michael Lucas James

Professor of Anesthesiology

With a clinical background in neuroanesthesia and neurointensive care, I have a special interest in translational research in intracerebral hemorrhage and traumatic brain injury. I am fortunate to be part of a unique team of highly motivated and productive individuals who allow me to propel ideas from bench to bedside and the ability to reverse translate ideas from the bedside back to the bench.

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