• Xiao Rao, Jiaqi Zhang, Kuangyang Yu, Yuxuan Sun, Jian Zhou, Lu Jiang, Tianjie Liu, Bingqing Xie, Jianhua Peng, and Yong Jiang.
• Department of Neurosurgery, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
• World Neurosurg. 2023 Jul 1; 175: e1059e1068e1059-e1068.

ObjectiveExternal ventricular drainage (EVD) is the most common neurosurgical procedure that allows drainage of cerebrospinal fluid and intraventricular blood. A specific time threshold for insertion of an EVD catheter in patients with spontaneous intracerebral hemorrhage and intraventricular hemorrhage has not been established. This study aimed to evaluate the association of early EVD with functional outcome in patients with intracerebral hemorrhage and intraventricular hemorrhage.MethodsPropensity score matching was used to account for baseline imbalances. Modified Rankin Scale score at 3 and 6 months, mortality rates at 3 and 6 months, postoperative complications, time course of edema evolution, and peak perihemorrhagic edema (PHE) were compared in patients who received early EVD versus routine EVD.ResultsThe rate of favorable outcome at 3 months was higher in the early EVD group compared with the routine EVD group. There were no differences between groups in modified Rankin Scale score at 6 months or mortality rates at 3 and 6 months. Absolute peak PHE and relative PHE volumes were significantly less in the early EVD group compared with the routine EVD group. The incidence of postoperative infections was lower in the early EVD group compared with the routine EVD group.ConclusionsEarly EVD was associated with improved functional outcome at 3 months, reduced PHE, and lower rate of infection in intracerebral hemorrhage and intraventricular hemorrhage. However, survival at 3 and 6 months and functional outcome at 6 months were not improved.Copyright © 2023 Elsevier Inc. All rights reserved.

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