Early shunt complications in 46 children with hydrocephalus

Braga, Moisés Heleno Vieira; Carvalho, Gervásio Teles Cardoso de; Brandão, Rafael Augusto Castro Santiago; Lima, Franklin Bernardes Faraj de; Costa, Bruno Silva

doi:10.1590/s0004-282x2009000200019

Cited by 37 publications

(32 citation statements)

References 15 publications

(22 reference statements)

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“…Factors including premature birth, occurrence of the first VPSI at a young age, congenital conditions such as meningomyelocele, post-hemorrhagic hydrocephalus, higher number of previous shunt infections, and the development of postoperative CSF leakage increase the risk of shunt infection (4,6,7,18,25). In this study, we found that children with VPSI in the first 3 months or with premature birth had a greater rate of shunt infections (high hospitalization coefficient) and higher treatment costs (high cost coefficient).…”

Section: Kanik a Et Al: Aspects Of Vps-related Infectionsmentioning

confidence: 55%

“…Shunt infections are caused by previous CSF infections or occur more generally due to skin contamination during surgical procedures (4,14). The surgeon's ability, speed, and experience; the timing of surgery; and the operating room conditions are controversial subjects in terms of the risk of The coefficient of cost…”

Section: Kanik a Et Al: Aspects Of Vps-related Infectionsmentioning

confidence: 99%

See 1 more Smart Citation

Clinic and economic results of the ventriculoperitoneal shunt infections in children

Kanık¹,

Sirin²,

Köse³

et al. 2014

Turkish Neurosurgery

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AIm: This study evaluated the clinical and economic outcomes of ventriculoperitoneal shunt infections. mATErIAl and mEThOds:Patients diagnosed with ventriculoperitoneal shunt infections for the first time between 1 January 2007 and 31 December 2011 were included in this study. Demographic, clinical, and economic data were analyzed retrospectively. A cost coefficient (total cost/follow-up period) and hospitalization coefficient (duration of hospitalization/follow-up period) were calculated for each patient. rEsulTs:In total, 132 shunt infections (mean follow-up, 734 ± 367 days) were evaluated in 51 patients (mean age, 16.6 ± 9.22 months; median age, 3 months; range, 1-88 months; 28 females, 21 males). In 23 patients (45%), shunt infections were seen in the first 2 months following shunt placement. Seven patients died during the follow-up. There was a negative correlation between the age at diagnosis and the hospitalization duration (p = 0.005, r = -0.381). The average cost of hospitalization per patient was 6397 ± 4338 TL. There was a negative correlation between the cost index and the age at diagnosis (p = 0.04, r = -0.292).CONClusION: Ventriculoperitoneal shunt infections have significant medical and economic impacts. Younger the diagnosis of patients, the hospitalization duration and treatment cost were higher. BulGulAr: Toplam 51 olgudaki (ortalama yaş: 2,58±1,75 ay; ortanca yaş: 3 ay: dağılım aralığı: 1-88 ay; 28 kız / 21 erkek) 132 şant enfeksiyonu (ortalama izlem süresi: 734± 367 gün) değerlendirilmeye alındı. Olguların 23'ünde (%45) ilk enfeksiyon şantın takılmasından sonraki ilk 2 ayda ortaya çıktı. Toplam yedi hasta izlemde kaybedildi. Olguların tanı yaşları ile yatış süresi katsayıları arasında negatif yönde anlamlı bir korelasyon olduğu görüldü (p=0,005; r = -0,381). Bir hasta için yatış başına düşen ortalama maliyet 6397±4338 TL olarak hesaplandı. Bu hastaların maliyet katsayısı ile tanı yaşı arasında negatif yönde anlamlı bir korelasyon saptandı (p=0,04; r = -0,292). sONuÇ: Ventriküloperitoneal şant enfeksiyonları ciddi tıbbi ve ekonomik sonuçlara neden olmaktadır. Hastaların tanı yaşı küçüldükçe hastanede yatış süreleri ve tedavi maliyetleri artmaktadır.

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Section: Kanik a Et Al: Aspects Of Vps-related Infectionsmentioning

confidence: 55%

Section: Kanik a Et Al: Aspects Of Vps-related Infectionsmentioning

confidence: 99%

Clinic and economic results of the ventriculoperitoneal shunt infections in children

Kanık¹,

Sirin²,

Köse³

et al. 2014

Turkish Neurosurgery

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“…VP shunt infection rates in pediatric patients have been reported to range from 8-20% 22,23) , depending on factors such as age, immune status, and comorbidities 5) . In pediatric patients, hemorrhage is less common than in adults, and brain tumors are the main cause for hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the parenteral vancomycin treatment for more than 2 weeks with appropriate serum drug levels (15-20 g/mL), the CSF was not sterilized and CoNS con μ -tinued to grow from EVD samples. Rifampin (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) mg/kg/day) was added to the therapy and the CSF culture finally became negative after this combination therapy without complications (9 days and 15 days of combination therapy, respectively). The EVDs were removed and new VP shunts were inserted.…”

Section: Diagnosis Of Vp Shunt Infections In Children Ismentioning

confidence: 99%

A Fifteen-year Epidemiological Study of Ventriculoperitoneal Shunt Infections in Pediatric Patients: A Single Center Experience

Kim

Shin

Kim

2012

Korean J Pediatr Infect Dis

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“…2,8,26,32,37,[47][48][49] At present, there are several publications addressing pediatric VPS failure and/or its associated complications. However, we note that the majority of such literature tends to focus on early complicationsusually where the VPS fails within 1 or 2 years postoperatively.…”

Section: Neurosurg Focus 41 (5):e7 2016mentioning

confidence: 99%

Late pediatric ventriculoperitoneal shunt failures: a Singapore tertiary institution's experience

Lee

Low

et al. 2016

FOC

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OBJECTIVE The introduction of ventriculoperitoneal shunts changed the way hydrocephalus was treated. Whereas much is known about the causes of shunt failure in the first few years, there is a paucity of data in the literature regarding the cause of late shunt failures. The authors conducted a study to find out the different causes of late shunt failures in their institution. METHODS A 10-year retrospective study of all the patients who were treated in the authors' hospital between 2006 and 2015 was conducted. Late shunt failures included those in patients who had to undergo shunt revision more than 5 years after their initial shunt insertion. The patient's notes and scans were reviewed to obtain the age and sex of the patient, the time it took for the shunt to fail, the reason for failure, and the patient's follow-up. RESULTS Forty-six patients in the authors' institution experienced 48 late shunt failures in the last 10 years. Their ages ranged from 7 to 26 years (12.23 ± 4.459 years [mean ± SD]). The time it took for the shunts to fail was between 6 and 24 years (mean 10.25 ± 3.77 years). Reasons for failure resulting in shunt revision include shunt fracture in 24 patients (50%), shunt blockage in 14 patients (29.2%), tract fibrosis in 6 patients (12.5%), shunt dislodgement in 2 patients (4.2%), and shunt erosion in 2 patients (4.2%). Postoperative follow-up for the patients ranged from 6 to 138 months (mean 45.15 ± 33.26 months). CONCLUSIONS Late shunt failure is caused by the effects of aging on the shunt, and the complications are different from early shunt failure. A large proportion are complications associated with shunt calcification. The authors advocate a long follow-up for pediatric patients with shunts in situ to monitor them for various causes of late shunt failure.

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Early shunt complications in 46 children with hydrocephalus

Cited by 37 publications

References 15 publications

Clinic and economic results of the ventriculoperitoneal shunt infections in children

Clinic and economic results of the ventriculoperitoneal shunt infections in children

A Fifteen-year Epidemiological Study of Ventriculoperitoneal Shunt Infections in Pediatric Patients: A Single Center Experience

Late pediatric ventriculoperitoneal shunt failures: a Singapore tertiary institution's experience

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