Predictors and Outcome of Ventriculoperitoneal Shunt Infection: A Retrospective Single-Center Study.

ABSTRACT

BACKGROUND: Shunt infection critically affects approximately 8-10% of all inserted shunts, leading to significant morbidity and mortality. This study aimed to assess the clinical and laboratory factors associated with shunt infection and outcomes in patients treated for hydrocephalus. Methods: A retrospective study was performed on patients who underwent ventriculoperitoneal shunt (VPS) surgery for hydrocephalus between January 2015 and June 2018. The primary outcome was the development of shunt infection following VPS surgery. Records were reviewed, and variables were analyzed, including patients' demographics, perioperative laboratory and shunt data, and outcomes. The patients had five years of follow-up from surgery, including a minimum of two years from the onset of VPS infection. RESULTS: A total of 132 shunts were inserted in 103 patients with a mean age of 2 years (range; 2 days to 73 years), and 53.4% were males. Twenty-two patients were suspected of having VPS infection (16.7% per procedure); only six (4.5%) had positive cerebrospinal fluid (CSF) detected organisms. Patients with preoperative hemoglobin, white blood cells, and serum glucose within normal values had a lower shunt infection rate. The pediatric population had an elevated risk of VPS infection, particularly those who underwent surgery at a younger age than 7.5 months, weighed less than 10 Kg, and were associated with myelomeningocele. in addition, a shorter surgery time of less than 82 min, single surgeon, and operating room of fewer than four attendees are associated with lower risk of VPS infection. CONCLUSION: We emphasize that early identification and modifications of the risk factors can minimize the probability of developing VPS infection and improve patients outcome.