Combination of Conventional EVD and Ommaya Drainage for Intraventricular Hemorrhage (IVH)

Abstract

Background

The effect of Ommaya reservoirs on the clinical outcomes of patients with intraventricular hemorrhage (IVH) remains unclear.

Objective

We aimed to determine the effect of combining the Ommaya reservoir and external ventricular drainage (EVD) therapy on IVH and explore better clinical indicators for Ommaya implantation.

Methods

A retrospective analysis was conducted on patients diagnosed with IVH who received EVD-Ommaya drainage between January 2013 and March 2021. The patient population was divided into two groups: the Ommaya-used group, comprising patients in whom the Ommaya drainage system was activated post-surgery, and the Ommaya-unused group, comprising patients in whom the system was not activated. The study analyzed clinical, imaging, and outcome data of the patient population.

Results

A total of 123 patients with IVH were included: 75 patients in the Ommaya-used group and 48 patients in the Ommaya-unused group. The patients in the Ommaya-used group showed a lower 3-month GOS than those in the Ommaya-unused group (p<0.0001). The modified Graeb scale (mGS) in the Ommaya-unused group was significantly lower than that in the Ommaya-used group before the operation (p<0.01) but not after surgery (p>0.05). The GCS in the Ommaya-used group was significantly lower than that in the other group, and there was a close correlation between the GCS and 3-month GOS (p<0.0001). The GCS score showed significance in predicting the use of Ommaya (p<0.001).

Conclusion

The study demonstrated that combining EVD and Ommaya drainage was a safe and feasible treatment for IVH. Additionally, preoperative GCS was found to predict the use of Ommaya drainage in subsequent treatment, providing valuable information for pre-surgery decision-making.

Keywords:

• intraventricular hemorrhage
• Ommaya
• external ventricular drainage

Data Sharing Statement

The data analyzed during the current study are available from the corresponding author Jin Hu on reasonable request.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Ethics Approval and Consent to Participate

The study was conducted in accordance with the ethical standards of the Helsinki Declaration of 1975. This study was approved by the institutional review board of Huashan Hospital, Fudan University (HIRB-2015-256). All participants provided written informed consent. The study was conducted in accordance with relevant guidelines and regulations.

Disclosure

The authors confirm that there are no competing interests.

Additional information

Funding

This work was supported by grants [No. 2022YFE0141300, No. 82271224, 2018YFA0107900, 92168103, 32171417, 2019CXJQ01], from National Key Research and Development Program of China, National Natural Science Foundation of China, Ministry of Science and Technology of China, National Nature Science Foundation and Shanghai Municipal Government, Peak Disciplines (Type IV) of Institutions of Higher Learning in Shanghai. Shanghai hospital development center, technology promotion, and management optimization in general hospitals [SHDC22023224, SHDC22022210], National High Level Hospital Clinical Research Funding [No. 2023-NHLHCRF-BQ-43].