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ISSN 2225-4676 (Electronic)

2020, Number 3

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Rev Cubana Neurol Neurocir 2020; 10 (3)

Factors influencing ventricular-peritoneal shunt failure in children and adolescents with hydrocephalus

Alonso FL, Leyva MT, Díaz ÁM

Language: Spanish
References: 33
Page: 1-26
PDF size: 499.09 Kb.


ABSTRACT

Objective: To identify the factors that influence the failure of ventricular-peritoneal shunt in children and adolescents with hydrocephalus.
Methods: A prospective cohort study was carried out with children and adolescents up to 18 years of age, of both sexes, who were admitted and operated on at Juan Manuel Márquez Pediatric University Hospital, from January 1, 2004 to December 31 2007, due to communicating and non-communicating hydrocephalus. They were followed up until December 2017. The sample was made up of 112 patients and the variables analyzed were age, sex, skin color, main imaging studies performed for diagnosis, cause of hydrocephalus, location of the catheter in the ventricle, type of shunt system used, surgical time, frequency of sepsis, and number of system failures. For the comparison of means, t-Student test and the association between variables (proportions) chi-square were used. In addition, the Kaplan-Meier method and Cox regression were used.
Results: Male sex predominated with 62 patients. The mean age of the series was one year, ranging between 6 hours old to 18 years old. Higher incidence was found in the group under 1 year of age (55 children). The most used diagnostic test was the skull axial tomography (56%) and acquired causes were more frequent (67%). Shunts with failed occipital location of the ventricular catheter prevailed in 75.5%. There was association between the mean surgical time and shunt sepsis, which was significantly higher in children who had more surgical time. Shunt failures occurred during the follow-up period in 62.5% of patients.
Conclusions: The associated factors with the shunt failure rate were the type of shunt system, the occipital location of the ventricular catheter, long surgical time, age minor than six months, and the hemorrhagic, tumor and post infectious causes of hydrocephalus.


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