Quality of Life in Individuals Surgically Treated for Congenital Hydrocephalus During Infancy: A Single-Institution Experience

Khan, Muhammad Faheem; Bakhshi, Saqib Kamran; Irfan, Omar; Khan, Hamza Abdur Rahim; Abbas, Asad; Awan, Safia; Bari, Muhammad Ehsan

doi:10.1016/j.wneu.2017.01.107

Cited by 7 publications

(5 citation statements)

References 29 publications

(43 reference statements)

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“…The literature about the QOL outcomes for kids with hydrocephalus is developing. This strategy would be especially beneficial in resource-constrained healthcare systems and developing countries like Pakistan, where hydrocephalus is the most prevalent neurological congenital disability and the most typical justification for pediatric patients to undergo neurosurgical intervention [19]. A more outcome-specific allocation of healthcare and social support may be made possible by identifying at risk for a bad outcome.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Assessing the Quality of Life in Hydrocephalic Children: A Study from Tertiary Care Hospitals in Pakistan

Khan,

Akbar,

Abbas

et al. 2024

Neuropediatrics

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Background: Hydrocephalus is a neurological disease with higher prevalence in the pediatric population, often managed by placing a shunt. This hollow tube drains excess cerebrospinal fluid from the brain to other body parts, resulting in several complications, including neurological and psychometric manifestations and a compromised quality-of-life (QoL). This study aimed to evaluate QoL in patients with hydrocephalus shunt placement within the pediatric population. Methods: This prospective observational study was conducted in two major Pakistani tertiary care hospitals. A total of 100 subjects were enrolled, of which 52 were found eligible. A validated questionnaire, HOQ, was used to evaluate patients' QoL. Results: This study included pediatric patients with a mean age of 6.54 and a standard deviation of ± 2.64. The male-to-female ratio was 27:25. 2% of patients had congenital or tumor-induced hydrocephalus, while cases of meningitis, encephalocele, and encephalitis accounted for 8, 4, and 2 percent respectively. Myelomeningocele had the highest prevalence at 16%. The overall health scores range from 0.39 to 0.51. Social, cognitive, and physical health scores have mean values of 0.54, 0.50, and 0.48, respectively. The minimum physical health score is 0.17, indicating the most significant impact of hydrocephalus on physical function. Conclusion: This study highlights variations in hydrocephalus severity among pediatric patients, impacting their overall QoL, primarily physical and behavioral functioning. Worse health outcomes were associated with frequent seizures, prolonged hospital stays for diagnosis and treatment, shunt infections, increased number of shunt catheters, and longer travel distances to medical facilities.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Assessing the Quality of Life in Hydrocephalic Children: A Study from Tertiary Care Hospitals in Pakistan

Khan,

Akbar,

Abbas

et al. 2024

Neuropediatrics

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“…PHH and subsequent CSF-shunting can provide significant functional impairment, reduce QoL, and requires additional neurosurgical intervention potentially increasing further complications, such as surgical revision due to occlusion, and high infection risk. 24,58,59 The results from Kulkarni et al 60 show that PHH and furthermore shunt-related infections significantly decrease QoL based on the Hydrocephalus Outcomes Scale, a validated survey tool to determine QoL outcomes secondary to PHH. This decrease was similar to the effect that epilepsy has on QoL shown in the literature.…”

Section: Effect Of Surgery Type On Hme Seizure Outcomementioning

confidence: 99%

Hemimegalencephaly: A Systematic Comparison of Functional and Anatomic Hemispherectomy for Drug-Resistant Epilepsy

Goel,

Ghadiyaram,

Krishnakumar

et al. 2023

Neurosurgery

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BACKGROUND AND OBJECTIVES: Hemimegalencephaly (HME) is a rare diffuse malformation of cortical development characterized by unihemispheric hypertrophy, drug-resistant epilepsy (DRE), hemiparesis, and developmental delay. Definitive treatment for HME-related DRE is hemispheric surgery through either anatomic (AH) or functional hemispherectomy (FH). This individual patient data meta-analysis assessed seizure outcomes of AH and FH for HME with pharmacoresistant epilepsy, predictors of Engel I, and efficacy of different FH approaches. METHODS: PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature were searched from inception to Jan 13th, 2023, for primary literature reporting seizure outcomes in >3 patients with HME receiving AH or FH. Demographics, neurophysiology findings, and Engel outcome at the last follow-up were extracted. Postsurgical seizure outcomes were compared through 2-tailed t-test and Fisher exact test. Univariate and multivariate Cox regression analyses were performed to identify independent predictors of Engel I outcome. RESULTS: Data from 145 patients were extracted from 26 studies, of which 89 underwent FH (22 vertical, 33 lateral), 47 underwent AH, and 9 received an unspecified hemispherectomy with a median last follow-up of 44.0 months (FH cohort) and 45.0 months (AH cohort). Cohorts were similar in preoperative characteristics and at the last follow-up; 77% (n = 66) of the FH cohort and 81% (n = 38) and of the AH cohort were Engel I. On multivariate analysis, only the presence of bilateral ictal electroencephalography abnormalities (hazard ratio = 11.5; P = .002) was significantly associated with faster time-to-seizure recurrence. A number-needed-to-treat analysis to prevent 1 additional case of posthemispherectomy hydrocephalus reveals that FH, compared with AH, was 3. There was no statistical significance for any differences in time-to-seizure recurrence between lateral and vertical FH approaches (hazard ratio = 2.59; P = .101). CONCLUSION: We show that hemispheric surgery is a highly effective treatment for HME-related DRE. Unilateral ictal electroencephalography changes and using the FH approach as initial surgical management may result in better outcomes due to significantly lower posthemispherectomy hydrocephalus probability. However, larger HME registries are needed to further delineate the predictors of seizure outcomes.

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“…19 Serupa dengan penelitian ini, penelitian terdahulu juga menunjukkan efek negatif komplikasi shunt terhadap luaran QoL, baik komplikasi infeksius 7,13 maupun komplikasi non-infeksius. 7,8,13,20 Komplikasi shunt sering timbul perlahan dengan gejala yang tidak jelas sehingga terlambat didiagnosis dan menyebabkan otak terpapar dengan tekanan intrakranial tinggi yang menyebabkan berbagai kerusakan. 2 Operasi ulang untuk tatalaksana komplikasi shunt juga telah diketahui merupakan faktor risiko kuat terjadinya komplikasi infeksius lebih lanjut.…”

Section: Pembahasanunclassified

“…25,26 Sesuai dengan penelitian ini, sebagian besar penelitian sebelumnya menunjukkan bahwa kejang merupakan faktor risiko kuat untuk terjadinya gangguan QoL. 5,7,8,13 Hasil analisis multivariat yang tidak bermakna pada penelitian ini kemungkinan dikarenakan jumlah sampel yang sedikit.…”

Section: Pembahasanunclassified

“…Usia yang lebih muda saat pemasangan, operasi ulang untuk revisi, dan adanya kejang dapat berdampak negatif terhadap kualitas hidup. 5,[7][8][9] Penelitian-penelitian lain juga menemukan bahwa etiologi hidrosefalus tertentu seperti perdarahan dan infeksi akan menyebabkan luaran kualitas hidup lebih buruk. 10,11 Penelitian ini bertujuan untuk menentukan luaran kualitas hidup anak berusia lebih dari lima tahun dengan hidrosefalus yang telah terpasang VP shunt dan mengetahui pengaruh berbagai faktor meliputi usia saat operasi, etiologi hidrosefalus, adanya kejang dan komplikasi shunt terhadap kualitas hidup.…”

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Faktor yang Memengaruhi Luaran Kualitas Hidup Anak dengan Hidrosefalus Setelah Pemasangan Shunt Ventrikulo-Peritoneal di Rumah Sakit Umum dr. Mohammad Hoesin Palembang

Desmita

Dewi

Darwin

et al. 2022

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Latar belakang. Anak hidrosefalus dengan VP shunt dapat mengalami penurunan kualitas hidup (QoL) akibat berbagai faktor yang hingga kini belum banyak diteliti.Tujuan. Menilai luaran QoL anak hidrosefalus dengan VP shunt dan faktor yang memengaruhinya.Metode. Anak berusia 5-18 tahun dengan hidrosefalus yang dipasang VP shunt tahun 2010-2015 diidentifikasi melalui rekam medis. Orangtua kemudian diwawancarai dengan panduan kuesioner HOQ (hydrocephalus outcome questionnaire). Hasil meliputi skor QoL pada aspek fisik, kognitif, dan keseluruhan. Skor 0 menunjukkan luaran terburuk dan skor 1 terbaik. Dilakukan analisis perbedaan skor berdasarkan faktor risiko (usia saat pemasangan, etiologi, adanya kejang dan komplikasi shunt) dan analisis kategorik berdasarkan pencapaian skor standar penelitian terdahulu (0,69).Hasil. Terdapat 95 anak yang diidentifikasi, 18 meninggal dan 46 dengan data tidak lengkap sehingga terdapat 31 anak yang dianalisis. Skor HOQ yang didapatkan, yaitu fisik 0,75±0,27, sosial-emosional 0,78±0,22, kognitif 0,66±0,31, dan keseluruhan 0,73±0,25. Skor HOQ keseluruhan lebih rendah pada anak dengan komplikasi. Kejang (RR 2,52) dan komplikasi shunt (RR 4,85) berhubungan dengan luaran buruk. Analisis multivariat menunjukkan hanya komplikasi yang berhubungan dengan QoL buruk (adjusted OR 15,11).Kesimpulan. Luaran QoL ditemukan lebih baik dibandingkan penelitian sebelumnya. Kejang dan komplikasi shunt dapat berpengaruh negatif terhadap luaran QoL anak hidrosefalus dengan VP shunt.

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Quality of Life in Individuals Surgically Treated for Congenital Hydrocephalus During Infancy: A Single-Institution Experience

Abstract: In our analysis, we assessed the QOL associated with CH. We hope that these results will provide insight for future prospective work with the ultimate goal of improving long-term QOL in children with CH.

Cited by 7 publications

References 29 publications

Assessing the Quality of Life in Hydrocephalic Children: A Study from Tertiary Care Hospitals in Pakistan

Assessing the Quality of Life in Hydrocephalic Children: A Study from Tertiary Care Hospitals in Pakistan

Hemimegalencephaly: A Systematic Comparison of Functional and Anatomic Hemispherectomy for Drug-Resistant Epilepsy

Faktor yang Memengaruhi Luaran Kualitas Hidup Anak dengan Hidrosefalus Setelah Pemasangan Shunt Ventrikulo-Peritoneal di Rumah Sakit Umum dr. Mohammad Hoesin Palembang

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