Long-term follow-up and comparison of programmable and non-programmable ventricular cerebrospinal fluid shunts among adult patients with different hydrocephalus etiologies: a retrospective cohort study.

Autor: Chen, Kuan-Hung, Hsu, Peng-Wei, Wu, Bo-Chang, Tu, Po-Hsun, Wang, Yu-Chi, Lee, Cheng-Chi, Huang, Yin-Cheng, Chen, Ching-Chang, Chuang, Chi-Cheng, Liu, Zhuo-Hao
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Zdroj: Acta Neurochirurgica; Sep2023, Vol. 165 Issue 9, p2551-2560, 10p
Abstrakt: Background: Programmable valve (PV) has been shown as a solution to the high revision rate in pediatric hydrocephalus patients, but it remains controversial among adults. This study is to compare the overall revision rate, revision cause, and revision-free survival between PV and non-programmable valve (NPV) in adult patients with different hydrocephalus etiologies. Method: We reviewed the chart of all patients with hydrocephalus receiving index ventricular cerebrospinal fluid (CSF) shunt operations conducted at a single institution from January 2017 to December 2017. Patients included in the study were followed up for at least 5 years. Statistical tests including independent t-test, chi-square test, and Fisher's exact test were used for comparative analysis, and Kaplan-Meier curve using log-rank test was performed to compare the revision-free survival between the PV and NPV groups. Results: A total of 325 patients were included in the study, of which 181 patients were receiving PVs and 144 patients receiving NPV. There were 23 patients (12.8%) with PV and 22 patients (15.3%) with NPV receiving initial revision. No significant statistical difference in the initial revision rate was observed between the two groups (p = 0.52). No survival difference was found between the PV and NPV groups. However, better revision-free survival was noted in the PV group among idiopathic normal pressure hydrocephalus (iNPH) (p = 0.0274) and post-traumatic hydrocephalus (p = 0.017). Conclusions: The combination of the different etiologies of hydrocephalus and the features of PV and NPV results in different outcomes—revision rate and revision-free survival. PV use might be superior to NPV in iNPH and post-traumatic hydrocephalus patients. Further studies are needed to clarify the indications of PV use in adult hydrocephalus patients. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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