Analysis of factors affecting the efficacy of lumboperitoneal shunt in the treatment of hydrocephalus

Abstract

Objective To screen factors influencing the neurological prognosis following lumboperitoneal shunt (LPS) in patients with hydrocephalus. Methods Total 136 patients who underwent LPS in Xuanwu Hospital, Capital Medical University from October 2014 to January 2020. The short-term neurological prognosis post - surgery were evaluated by modified Rankin Scale (mRS) at discharge. Univariate and multivariate stepwise Logistic regression analyses were conducted to screen factors affecting neurological prognosis. Results Of the 136 patients, 65 were categorized into the good prognosis group (mRS score ≤ 3), and 71 into the poor prognosis group (mRS score > 3). Logistic regression analysis indicated that an admission Glasgow Coma Scale (GCS) score of 9-12 (OR = 7.800, 95%CI: 7.205-8.443; P = 0.000) and 3-8 (OR = 6.299, 95%CI: 5.744-6.907; P = 0.006), as well as etiologies including traumatic brain injury (OR = 27.681, 95%CI: 24.270-31.572; P = 0.000), cerebral hemorrhage (OR = 13.017, 95%CI: 11.473-14.769; P = 0.005), subarachnoid hemorrhage (OR = 17.682, 95%CI: 15.683-19.935; P = 0.001), and other causes (OR = 5.851, 95%CI: 5.166-6.628; P = 0.050) were risk factors for poor short-term neurological prognosis in patients with hydrocephalus undergoing LPS. Conclusions The neurological prognosis after LPS in patients with hydrocephalus is influenced by multiple factors. Prognoses vary among patients with different admission GCS scores and different etiologies. Personalized treatment plans should be developed based on specific circumstances.

Keywords

• hydrocephalus
• cerebrospinal fluid shunts
• prognosis
• risk factors
• logistic models