Assessment of the Factors Influencing the Survival of the Ventricular Shunt in Infantile Hydrocephalus

Abstract

The purpose of the present research is to perform a retrospective analysis of 242 ventricular shunts implanted in childhood due to infantile hydrocephalus, submitted to a long-term follow-up (27.84 ± 6.13 years) and investigate the factors influencing the survival of the shunt, applying modern mathematical approaches. The contingent consists of 242 patients who were shunted due to infantile hydrocephalus in childhood, 55% of whom were under 6 months old when the shunt was implanted. For the entire follow-up period, patients underwent 375 revisions (average 1.55 revisions per shunt), 38% are without shunt failure, with only one revision – 26%, with two – 14%. The remaining 22% have 3 or more revisions (4.58 shunt revisions) and they make 65% of all revisions. 68.5% of all revisions are due to mechanical complications; to functional (inadequate drainage) – 7.5%. 9.1% of the patients had inflammatory complications. We found that the age at shunting (under 3 months – the worst trend) and the interval to the first revision (over 6 months – a smaller number of revisions) are of the biggest importance for the number of the following revisions. If the patient survives one year after shunting without failure, the risk of such is under 50% during the whole shunt existence.

Keywords

• infantile hydrocephalus
• shunt complications
• shunt survival
• pediatric neurosurgery
• intercriteria analysis