Role of external ventricular drainage in spontaneous intraventricular haemorrhage patients in cileungsi district hospital

Abstract

Background: Intraventricular haemorrhage (IVH) worsen the prognosis of Intracerebral hematoma (ICH). External Ventricular Drain (EVD) is inserted to reduce intracranial pressure that resulted from the progression of IVH. However, EVD is still an optional procedure because it is not always proven effective. This study was aimed to demonstrate prognostic factors of IVH and whether EVD insertion might improve the outcome. Methods: This cross-sectional retrospective study included IVH patients and concomitant ICH-IVH that required or not EVD in Cileungsi Hospital from January to December 2018. We made comparisons between EVD insertion group and non-EVD group based on sex, age, pulse pressure, Glasgow Coma Scale (GCS), bleeding volume, score of bleeding volume in ventricle lateral, third and fourth based on CT scan, Charlson Comorbid Index (CCI) and modified Rankin Scale (mRS). To determine factors contributing to the good prognosis of EVD, Spearman Correlation test was used with STATA 15 software. Results: 100 patients were diagnosed with ICH, five patients IVH, 16 patients ICH and IVH. Blood in the fourth ventricle made a significant difference between EVD and non-EVD groups in the concomitant ICHIVH group (p=0.035). GCS score (p=0.034) correlated significantly with the prognosis of concomitant ICHIVH patients that had EVD insertion with correlation coefficient 0.671. EVD did not improve the outcome in IVH patients nor patients with ICH-IVH. Conclusion: EVD did not improve the prognosis of spontaneous concomitant ICH-IVH or spontaneous IVH patients, but it still needs to be inserted in case of developing obstructive hydrocephalus that might be lethal. (Health Science Journal of Indonesia 2020;11(1):1-8)