{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T22:03:58Z","timestamp":1764194638045,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ventriculostomy\u2010related infection (VRI) is a common complication in patients with traumatic brain injury (TBI) treated with an external ventricular drain (EVD). The aim of this study was to investigate incidence and characteristics of patients with VRI, and to explore diagnostic criteria to confidently rule out VRI in patients with TBI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort pilot study included adults with severe TBI who were admitted to the ICU and received an EVD, during a 26\u2010month period. Patients were categorized as having <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>positive VRI<\/jats:italic>, <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>negative VRI<\/jats:italic>, or <jats:italic>No VRI<\/jats:italic>. Variables that were potentially associated with <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>positive VRI<\/jats:italic> was analyzed, and predictive values were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>75 of 215 patients with severe TBI (35%) underwent EVD placement; nine of these (12%) were classified as <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>negative VRI<\/jats:italic> and eight (11%) as <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>positive VRI<\/jats:italic>. The CSF cell counts that led to VRI treatment were compared with 46 CSF cell counts from <jats:italic>No VRI<\/jats:italic> patients. A CSF\/plasma glucose ratio below 0.6\u00a0had a negative predictive value (NPV) for culture\u2010verified VRI of 0.97 (95% CI: 0.85\u20131), whereas a combination of three CSF\u2010derived biomarkers within the reference limits (white\/red blood cell ratio, CSF\/plasma glucose ratio, and protein content) ruled out <jats:italic>Culture<\/jats:italic>\u2010<jats:italic>positive VRI<\/jats:italic> in this cohort (PPV 0, 95% CI: 0\u20130.14). C\u2010reactive protein did not reliably predict VRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this pilot study of patients after severe, a combination of biomarkers within reference limits ruled out VRI (PPV 0, CI: 0\u20130.14). Hypoglycorrhachia was a sensitive marker of VRI (NPV 0.97, CI: 0.85\u20131). Systemic signs and markers of infection did not predict VRI.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14036","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T08:28:11Z","timestamp":1643963291000},"page":"507-515","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic criteria of CNS infection in patients with external ventricular drainage after traumatic brain injury: a pilot study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-6080","authenticated-orcid":false,"given":"Rasmus Stanley","family":"Willer\u2010Hansen","sequence":"first","affiliation":[{"name":"Department of Neuroanaesthesiology Neuroscience Centre Rigshospitalet University of Copenhagen  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0981-0723","authenticated-orcid":false,"given":"Markus Harboe","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology Neuroscience Centre Rigshospitalet University of Copenhagen  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6548-5975","authenticated-orcid":false,"given":"John","family":"Hauerberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Neuroscience Centre Rigshospitalet University of Copenhagen  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-3717","authenticated-orcid":false,"given":"Helle Krogh","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Diagnostic Centre Rigshospitalet University of Copenhagen  Denmark"},{"name":"Department of Infectious Diseases Heart Centre Rigshospitalet University of Copenhagen  Denmark"},{"name":"Department of Clinical Medicine Faculty of Health Sciences University of Copenhagen  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4779-7603","authenticated-orcid":false,"given":"\u00c5se Bengaard","family":"Andersen","sequence":"additional","affiliation":[{"name":"Novo Nordisk Foundation Center for Biosustainability Technical University of Denmark  Kgs. Lyngby Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-1072","authenticated-orcid":false,"given":"Kirsten","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology Neuroscience Centre Rigshospitalet University of Copenhagen  Denmark"},{"name":"Department of Infectious Diseases Heart Centre Rigshospitalet University of Copenhagen  Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0963689717714102"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-013-9885-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001432"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0199-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/324492"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.12.071"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-018-1173-x"},{"key":"e_1_2_8_9_1","first-page":"PC06","article-title":"Inflammation and outcome in traumatic brain injury: does gender effect on survival and prognosis?","volume":"11","author":"Naghibi T","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-029072"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.01.012"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-004-0258-8"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198403013100903"},{"key":"e_1_2_8_14_1","first-page":"114","article-title":"Studies of the transport of sugars between blood and cerebrospinal fluid in normal states and in meningeal carcinomatosis","volume":"88","author":"Fishman RA","year":"1963","journal-title":"Trans Am Neurol Assoc"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1111080"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008552"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200207000-00024"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2017.07.012"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14036","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.14036","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T19:44:13Z","timestamp":1692992653000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.14036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,14]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1111\/aas.14036"],"URL":"https:\/\/doi.org\/10.1111\/aas.14036","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"type":"print","value":"0001-5172"},{"type":"electronic","value":"1399-6576"}],"subject":[],"published":{"date-parts":[[2022,2,14]]},"assertion":[{"value":"2020-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}