Early Postoperative Outcomes of Normal Pressure Hydrocephalus
| Autor: | Simon D Thompson, Jonathan P Funnell, Aida K Golahmadi, Laurence D Watkins, Claudia Craven, Ahmed K Toma, Michelle Leemans, Darreul Sewell, Astri M V Luoma, Lewis Thorne, Shivani Manohara, Susannah Worby, Linda D'Antona, Sandra C Blamey |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Preoperative risk Ventriculoperitoneal Shunt Neurosurgical Procedures law.invention 03 medical and health sciences Postoperative Complications 0302 clinical medicine Lumbar 030202 anesthesiology Normal pressure hydrocephalus law medicine Humans Prospective Studies Aged Surgical complication business.industry Surgical procedures medicine.disease Intensive care unit Cerebrospinal Fluid Shunts Hydrocephalus Normal Pressure Surgery Treatment Outcome Anesthesiology and Pain Medicine Neurology (clinical) Postoperative nausea Neurosurgery business 030217 neurology & neurosurgery Hydrocephalus |
| Zdroj: | Journal of Neurosurgical Anesthesiology. |
| ISSN: | 0898-4921 |
| DOI: | 10.1097/ana.0000000000000668 |
| Popis: | Background Patients with normal pressure hydrocephalus (NPH) are often elderly, frail and affected by multimorbidity. Treatment is surgical with cerebrospinal diversion shunts. The selection of patients that are of an acceptable level of risk to be treated surgically has been a matter of debate for years and has deprived some patients of life-changing surgery. The aim of this service evaluation was to investigate the preoperative risk factors and early postoperative morbidity of patients with NPH using a standardized postoperative survey. Materials and methods Consecutive NPH patients admitted for neurosurgical management of NPH between May 2017 and May 2018 were included in this prospective service evaluation. In addition to the collection of traditional outcome measures, the cardiac version of the Postoperative Morbidity Survey (C-POMS) was conducted on postoperative days 4, 7, and 10 to identify postoperative morbidity. Results Eighty-eight patients (63 males, age mean±SD, 75±7 y) underwent 106 surgical procedures (61 lumbar drains, 45 ventriculoperitoneal shunts). There was no 30-day mortality and no unexpected return to the operating room or admission to intensive care unit. There was 1 conservatively managed surgical complication. On postoperative day 4, the C-POMS identified no postoperative morbidity in 72% of the patients, and mild morbidity (postoperative nausea and mobility issues) in 28%. There was a delay in discharge in 50% of the patients with no postoperative morbidity on day 4, highlighting areas of our service requiring improvement. Conclusions Early postoperative outcomes of NPH patients are good after both ventriculoperitoneal shunt insertion and lumbar drainage. This evaluation provides initial evidence on the utility of the C-POMS as a service evaluation tool in the standardized assessment postoperative outcomes in neurosurgery patients. |
| Databáze: | OpenAIRE |
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