title: Meta-analysis of hemorrhagic complications from ventriculostomy placement by neurosurgeons.
abstract: BACKGROUND
  Ventriculostomy placement is an important diagnostic and therapeutic tool for neurosurgeons. Multiple authors have presented retrospective series of patients evaluating periprocedure hemorrhage.
  
  
  OBJECTIVE
  We performed a meta-analysis of existing studies to determine a more accurate rate of hemorrhage.
  
  
  METHODS
  A MEDLINE and PubMed search was performed to find all studies of 25 or more patients conducted since 1970 that found a hemorrhagic complication rate from placement of a ventriculostomy. Studies in which a non-neurosurgeon placed the ventriculostomy and studies involving premature infants were excluded.
  
  
  RESULTS
  Sixteen studies were used to obtain data from 2428 ventriculostomy procedures. Hemorrhage was found after 203 procedures, and 52 of these hemorrhages were deemed significant by the authors. The cumulative rate of hemorrhage was 7.0% (95% confidence interval: 4.5%-9.4%), with P < .05. The cumulative rate of significant hemorrhage was 0.8% (95% confidence interval: 0.2%-1.4%) with P < .05.
  
  
  CONCLUSIONS
  Based on our meta-analysis, the overall hemorrhagic complication rate from ventriculostomy placement by neurosurgeons is approximately 7%. The rate of significant hemorrhage from ventriculostomy placement is approximately 0.8%. Further prospective studies are warranted to better address this question.
authors.affiliation: Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-3410, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Bauer
authors.forename: Shantanu N
authors.initials: SN
authors.lastname: Razdan
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Bartolucci
authors.forename: James M
authors.initials: JM
authors.lastname: Markert
mesh_terms: D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000209:etiology*; D010820:Physicians; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D014696:Ventriculostomy / Q000009:adverse effects*