Mechanical complications of cerebrospinal fluid shunt. Differences between adult and pediatric populations: myths or reality?
| Autor: | Emmanuel de Schlichting, Aurélien Coste, Laurent Sakka, Jean Chazal, Guillaume Coll, Hugo Peyre, Francis Abed Rabbo, Jean-Marc Garcier |
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| Rok vydání: | 2020 |
| Předmět: |
Shunt placement
Adult Reoperation medicine.medical_specialty Ventriculoperitoneal Shunt 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Medicine Humans Child Retrospective Studies business.industry Incidence (epidemiology) Infant Retrospective cohort study General Medicine medicine.disease Cerebrospinal Fluid Shunts Hydrocephalus Shunt (medical) Surgery Cerebrospinal fluid shunt 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. 37(7) |
| ISSN: | 1433-0350 |
| Popis: | Shunt malfunctions seem more frequent in children (44 to 81%) than in adults (18 to 29%). Because of discrepancies between studies, it is not possible to affirm this disparity. The objective was to verify whether the incidence of cerebrospinal fluid (CSF) shunt malfunctions is higher in children than adults. We present a retrospective series of child and adult patients who underwent CSF shunt placement between 2000 and 2013 with a Sophysa SM8® valve. 599 adults and 98 children (sex ratio 1.28) underwent CSF shunt placement. Age at first surgery ranged between 1 day of life and 90 years (mean of 55.8 years, SD 25.8, median 64.8 years). The mean follow-up was 4 years (SD 4.264, 0–16; median 3 years). The cumulative complication rate was 25.5% (178/697). Mechanical complications were disconnection (25.1%), migration (11.8%), intracranial catheter obstruction (8.9%) and malposition (8.4%). The mean delay for the first revision was 1.90 years (0–13.9), (SD 2.73, median 0.5). The probability of shunt failure was 65% at 10 years in the child group and 36% at 10 years in the adult group. Moreover, in the child group, 33% of revisions occurred during the first year after shunt placement versus 17% in the adult group. Thus, the probability of shunt failure was higher in children than in adults (log-rank test, p < 0.001). This is the first retrospective study, comparing children and adults undergoing CSF shunt using the same valve, able to confirm the higher rate of complications in children. |
| Databáze: | OpenAIRE |
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