Long-term outcome after treatment of hydrocephalus in children.
Pediatr Neurosurg
; 46(3): 221-6, 2010.
Article
em En
| MEDLINE
| ID: mdl-21051921
ABSTRACT
AIMS:
To provide long-term outcome data after treatment of hydrocephalus in children, and to identify risk factors for ventriculoperitoneal shunt (VPS) failure.METHODS:
Endoscopic third ventriculostomy (ETV) and VPS procedures in children between 2001 and 2005 were reviewed. Data collected prospectively included age at surgery, sex, aetiology of hydrocephalus, gestational age, emergency/planned surgery, duration of surgery, time of day, surgeon's experience and other concomitant surgery. The mean follow-up was 4.7 years (min. 2 years). The endpoint was a new surgery due to failure of treatment, and the time to failure was noted. Risk factors for VPS failure were analysed by univariate Cox proportional hazards regression.RESULTS:
Ninety-eight patients were included, 76 with a VPS, 22 with an ETV. Fifty-five percent of ETV and 58% of VPS failed. Significant risk factors (p < 0.05) for VPS failure were prematurity (HR 2.05; 95% CI 1.12-3.76), concomitant procedure (HR 2.07; 95% CI 1.04-4.12) and long duration of surgery (HR 1.23; 95% CI 1.06-1.44), while sex, surgeon's experience, shunt type, at what department the surgery was performed, whether the surgery was acute or elective, and time of day were not.CONCLUSION:
Treatment failure occurred in >50% of patients after ETV and VPS. Prematurity and concomitant surgery were major risk factors for VPS failure.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Ventriculostomia
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Derivação Ventriculoperitoneal
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Hidrocefalia
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article