Ventriculitis characteristics and outcomes (VELCRO): an international retrospective cohort study
Makaleler > Tam Makale · 2025
Yazarlar: David Luque Paz, Beatriz Díaz-Pollán, Marielle Boyer-Besseyre, Flora Djanikian, Anne-Lise Munier, Flávia Cunha, Lélia Escaut, Guillaume Martin-Blondel, Benjamine Sarton, Pierre Jaquet, François Arrivé, Rémi Wolf, Vincent Legros, Mathieu Willig, Oguz Resat Sipahi, Laure Flurin, Antoine Bianchi, Baptiste Balança, Alejandro Díez-Vidal, Joshua Puel, Benjamin Soyer, Rita Lino, Thibaut Leveque, Alexis Salomon, Alexandra Serris, Romaric Larcher, Fabrice Bruneel, Nicolas Mongardon, Martin Martinot, Aurélien Mazeraud, Michel Wolff, Romain Sonneville, Florent Valour, Pierre Tattevin, Alexis Salomon, Paul Jaubert, Ivan Pelegrin, María Milagros Montero, Pierre Bailly, Thibaut Leveque, Martin Martinot, Nicolas Mongardon, Mathieu Willig, Rémi Wolf, Oguz Resat Sipahi, Gamze Şanlıdağ İşbilen, Florent Valour, Florian Contard, Baptiste Balança, Pierre Goffin, Marielle Boyer-Besseyre, Beatriz Díaz-Pollán, Alejandro Díez-Vidal, Fernando Fernández Hinojal, Antoine Bianchi, Flora Djanikian, Joshua Puel, Lélia Escaut, Anne Herbrecht, Pierre Etienne Leblanc, Nicolas Fortineau, Laure Flurin, Romain Sonneville, Sarah Benghanem, Anne-Lise Munier, Benjamin Soyer, Alexandra Serris, Clémentine De La Porte Des Vaux, Fanny Lanternier, Alexandra Beurton, Aurélien Mazeraud, Michel Wolff, Romaric Larcher, Flávia Cunha, Rita Lino, Lurdes Santos, François Arrivé, Vincent Legros, François Eugène, David Luque Paz, Pierre Tattevin, Matthieu Revest, Pierre-Jean Le Reste, Pierre Jaquet, Marco Seneghini, Werner Albrich, Mathilde Zenou, Baptiste Jean, Benjamine Sarton, Guillaume Reiter, Delphine Dghayem, Fabrice Bonneville, Guillaume Martin-Blondel, Vanessa Jean-Michel, Florian Reizine, Fabrice Bruneel
Brain, Uluslararası, Wos, 2025, cilt 149, ss 333-342
Özet
Ventriculitis is a dreaded complication of central nervous system infections, which has been scarcely described in the literature. We aimed to present a contemporary picture of ventriculitis, describing its characteristics and outcomes across the spectrum of aetiologies that may lead to ventriculitis. VELCRO is an international retrospective multicentre cohort study conducted at 34 hospitals in six countries. Adult patients fulfilling the clinical, microbiological and imaging criteria for ventriculitis between 2010 and 2021 were included. Survival analyses were performed using a multivariable Cox proportional hazards regression model to identify risk factors for 1-year all-cause mortality. Overall, 436 patients with ventriculitis were included [274 (62.8%) males, median age 58 years (interquartile range 48-68); 68 (15.6%) had diabetes mellitus and 62 (14.2%) were immunocompromised]. The most common neuroimaging features of ventriculitis were ependymal enhancement (n = 310/436, 71.1%), intraventricular pus (n = 286/436, 65.6%) and intraventricular septations (n = 85/436, 19.5%). To describe the cohort, patients were divided into three groups: ventriculitis with brain abscess(es) (V-BA, n = 181), community-acquired ventriculitis without brain abscess (CA-V, n = 88), and healthcare-associated ventriculitis without brain abscess (HCA-V, n = 167). Intensive care unit admission was required for 351 patients (80.5%), and the median hospital length of stay was 45 days (range 26-74). One-year mortality rate was 33.7% (n = 147/436), with a lower rate in patients with V-BA (n = 50/181, 27.6%) than in patients with CA-V (n = 30/88, 34.1%) and HCA-V (n = 67/167, 40.1%). On multivariable analysis, the predictive factors for 1-year mortality were: age > 60 years, immunosuppression, diabetes mellitus, Glasgow Coma Scale score < 13 at presentation, infection involving Enterobacterales or fungi, acute hydrocephalus, cerebral ischaemia and intraventricular septations. Staphylococcal ventriculitis was associated with a lower 1-year mortality. Long-term unfavourable outcome [modified Rankin score (mRS) >2 after 6 months of follow-up] occurred in 43.3% (n = 91/210), considering that 26.7% (n = 56) had a mRS >2 before the onset of ventriculitis. Ventriculitis is associated with high mortality and neurological morbidity. Further large prospective studies are needed in this area of research.