Shunting outcomes in post-hemorrhagic hydrocephalus

Guan, Junwen; You, Chao; Yang, Jingguo; Li, Xuepei; Yuan, Yikai; Zhou, Yubin

doi:10.1097/md.0000000000021640

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Medicine

2020

DOI: 10.1097/md.0000000000021640

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Shunting outcomes in post-hemorrhagic hydrocephalus

Junwen Guan¹,

Chao You²,

Jingguo Yang³

et al.

Abstract: Background: The best treatment option for patients with post-hemorrhagic hydrocephalus (PHH) remains controversial. The objective of the current meta-analysis is to systematically evaluate the long-term outcomes of patients with PHH treated by ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS). Methods: We search literatures through PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), the Chinese Science and Tec… Show more

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Cited by 3 publications

References 15 publications

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Prediction of adult post-hemorrhagic hydrocephalus: a risk score based on clinical data

Wang

et al. 2022

Sci Rep

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There is lacking research on risk factors and prediction models associated with Post-hemorrhagic hydrocephalus (PHH). Thus, this present study aimed to analyze the risk factors of PHH and establish a risk-scoring system through a large-scale study. A retrospective study of 382 patients with intracranial hemorrhage assessed age, history and diagnosis, Glasgow coma score (GCS), and fever time. After univariate and logistic regression analysis, a risk scoring system was established according to independent risk factors and evaluated using the area under the curve (AUC). Of the 382 patients, 133 (34.8%) had PHH, 43 (11.3%) received surgical treatment. Factor classification showed that age > 60 years old [odds ratio (OR): 0.347, II = 5 points], GCS < 5 (OR: 0.09, IV = 10 points), GCS 6‒8 (OR = 0.232, III = 6 points), fever time > 9 (OR: 0.202, III = 7 points), fever time 5–9 (OR: 0.341, II = 5 points), CSF-TP x time > 14,4000 group (OR: 0.267, IV = 6 points), and CSF-TP x time 9,601‒14,400 group (OR: 0.502, III = 3 points) were independent risk factors. The result of the receiver operating characteristic (ROC) prediction showed that AUC = 0.790 (0.744‒0.836). Low-risk (IV-VII), moderate (VIII-X), and high-risk group (XI-XIII) incidence of PHH were 11.76%, 50.55%, and 70.00% (p < 0.001), respectively. The coincidence rates in the validation cohort were 26.00%, 74.07%, and 100.0% (p < 0.001), respectively. AUC value was 0.860 (0.780‒0.941). The predictive model was conducive to determining the occurrence of PHH and facilitating early intervention.

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Prediction of adult post-hemorrhagic hydrocephalus: a risk score based on clinical data

Wang

et al. 2022

Sci Rep

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Risk Factor of Posthemorrhagic Hydrocephalus: Cerebrospinal Fluid Total Protein

et al. 2022

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ObjectiveCerebrospinal fluid total protein (CSF-TP) levels in adults with posthemorrhagic hydrocephalus (PHH) are poorly studied. The objective of this study was to explore the characteristics of CSF-TP levels in patients with PHH.MethodsThe clinical data of 156 patients with hemorrhagic brain disease were retrospectively studied and divided into PHH and NPHH groups. Single-factor and multi-factor analyses were performed, and the key role of CSF-TP was evaluated using linear analysis.ResultsAmong the 156 patients, 85 (54.5%) had PHH and 34 (21.8%) underwent surgeries. Hypertension (p = 0.017), days [total fever time when body temperature ≥ 38.5°C (p = 0.04)], Glasgow Coma Scale (GCS) score (p < 0.001), and time (from the onset of the disease to the obtainment of CSF-TP after lumbar puncture (p < 0.001) were important factors for PHH. Logistic regression analysis revealed that GCS score < 8 [odds ratio (OR) = 2.943 (1.421–6.097), p = 0.004] and CSF-TP × time ≥ 9,600 [OR = 2.317 (1.108–4.849), p = 0.026] were independent risk factors for PHH. All CSF-TP values were averaged every 2 days. CSF-TP was negatively correlated with time. Linear analysis showed that CSF-TP in the PHH group was higher than that in the NPHH group at the same onset time, and that the duration of detectionin the CSF was longer.ConclusionCerebrospinal fluid total protein (CSF-TP) × time ≥ 9,600 and GCS score <8 were independent risk factors for PHH. CSF-TP was higher in the PHH group than in the NPHH group.

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Comparative Outcomes and/or Complications Following Ventriculoperitoneal versus Lumboperitoneal Shunts: A Scoping Review

Maurya,

Mishra,

Sharma

et al. 2023

Journal of Medical Evidence

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Cerebrospinal fluid (CSF) diversion procedure in the form of ventriculoperitoneal shunt (VPS) has been performed for over a century and is a well-established method for treating hydrocephalus. With the passage of time and the availability of better technology, several other CSF diversion modalities developed with variable risks and benefits. Lumboperitoneal shunt (LPS) is a close and safe contestant for the VP shunt procedure and is regarded as an alternative treatment modality for hydrocephalus. The present scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A literature search for the study was performed on PubMed, COCHRANE, SCOPUS and ScienceDirect (from inception to 7 July 2022). Those studies that were published in the English language with a report on comparison between VPS and LPS for the management of hydrocephalus were included in the review process. Those studies that do not have comparative outcomes, case reports, letters, reviews, preclinical studies, conference reports and non-human studies were excluded from the study. Search results showed 134 records; after removing the duplicates and excluding 12 studies with reasons, five studies were included in the present review. Several complications were described in patients who underwent either VP Shunt or LP Shunt surgery. Although communicating hydrocephalus forms one of the most significant subgroups of patients in neurosurgical practice and VP and LP shunt procedures are also widely performed, the literature review shows limited comparative efficacy. In addition, the reported studies have a broad spectrum of indications, disease conditions and complications with a heterogeneous patient population. To further develop the high level of evidence, there is a need for well-designed prospective protocols to help us develop uniform and practical guidelines. In the present review, we looked into the common complications, including shunt malfunction, shunt infection, subdural haematoma, shunt obstruction and shunt migration between two groups.

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Shunting outcomes in post-hemorrhagic hydrocephalus

Cited by 3 publications

References 15 publications

Prediction of adult post-hemorrhagic hydrocephalus: a risk score based on clinical data

Prediction of adult post-hemorrhagic hydrocephalus: a risk score based on clinical data

Risk Factor of Posthemorrhagic Hydrocephalus: Cerebrospinal Fluid Total Protein

Comparative Outcomes and/or Complications Following Ventriculoperitoneal versus Lumboperitoneal Shunts: A Scoping Review

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