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Neurosurgery:
doi: 10.1227/01.NEU.0000319527.34738.9D
Clinical Studies

LOWER INCIDENCE OF REOPERATION WITH LONGER SHUNT SURVIVAL WITH ADULT VENTRICULOPERITONEAL SHUNTS PLACED FOR HEMORRHAGE‐RELATED HYDROCEPHALUS

Hoh, Brian L. M.D.; Lang, Shih-Shan M.D.; Ortiz, Michael V. B.S.; Chi, Yueh-Yun Ph.D.; Lewis, Stephen B. M.D.; Pincus, David W. M.D., Ph.D.

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Abstract

OBJECTIVE: The incidence of reoperation for ventriculoperitoneal shunts (VPS) in adults, although lower than in pediatric patients, is not insignificant. We hypothesize that adult VPS placed for hemorrhage-related hydrocephalus have a lower incidence of reoperation than those placed for other types of hydrocephalus.

METHODS: We retrospectively reviewed all adult (≥ 20 yr) VPS initially placed from February 2001 to August 2006 at the University of Florida. We determined the incidence and time interval to reoperation. Follow-up was conducted by telephone interview and review of medical records.

RESULTS: A total of 286 adult VPS were initially placed: 96 (34%) hemorrhage and 190 (66%) nonhemorrhage. A total of 15 (16%) hemorrhage patients underwent 22 shunt reoperations, compared with 50 (27%) nonhemorrhage patients who underwent 82 shunt reoperations (P = 0.0316). A Poisson regression analysis of the number of reoperations, factoring hemorrhage, age, and sex, demonstrated a significantly lower incidence of reoperation in hemorrhage patients (P = 0.0900). A Cox proportional hazards model analysis of time to first reoperation, factoring hemorrhage, age, and sex, demonstrated a significantly longer shunt survival in hemorrhage patients (P = 0.0404).

CONCLUSION: Adult VPS placed for hemorrhage-related hydrocephalus have a significantly lower incidence of reoperation and significantly longer shunt survival. This result may be related to an incidence of transient shunt dependency in patients with hemorrhage-related hydrocephalus. However, the precise mechanism remains unclear.

Copyright © by the Congress of Neurological Surgeons

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