Hydrocephalus, Ventriculoperitoneal Shunt Malfunction
Conditions
Keywords
Hydrocephalus, Programmable shunt, Long-term outcome
Brief summary
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.
Detailed description
Relatively high revision rates up to 32% of CSF shunting operations remained an unsolved problem for neurosurgeons. The cause of revisions were diverse, including overdrainage/underdrainage, shunting system obstruction, infection or technical skill related. 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. The investigators reviewed the chart of all patients with hydrocephalus receiving index ventricular CSF shunt operations conducted at a single institution in northern Taiwan from January 2017 to December 2017. Patients included in the study were followed up for at least five 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
Interventions
DEVICEProgrammable valve
Programmable valve used in the study included Medtronic Strata, B-Braun ProGav, Codman Certas.
DEVICENon-programmable valve
Non-programmable valve used in the study was Medtronic CSF-flow control valve.
Sponsors
Ministry of Science and Technology, Taiwan
Chang Gung Memorial Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* received shunting operations at Chang Gung Medical Foundation, Linkou Branch from 2017/01/01\ 2017/12/31
Exclusion criteria
* Patients who received index ventricular CSF shunt at other hospitals, * Patients who received index ventricular CSF shunt before January 1st 2017, * Patients who were younger than 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Initial Shunt revision rate | since the time of index operation until the initial revision or 2022/07/31 | the ratio of the total number of patients with at least one revision to the total number of patients included in this study |
| Total Shunt revision rate | since the time of index operation until the initial revision or 2022/07/31 | the ratio of the total number of revisions to the total number of ventricular CSF shunt operations |
| The cause of shunt revision | since the time of index operation until the initial revision or 2022/07/31 | the cause of the shunt malfunction warranting revision operation |
| Type of the revision operation | since the time of index operation until the initial revision or 2022/07/31 | the detailed description of the revision operation |
| Revision-free survival | since the time of index operation until the initial revision or 2022/07/31 | the interval between index operation and the initial revision |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Shunt revision-free survival among different hydrocephalus etiologies | since the time of index operation until the initial revision or 2022/07/31 | the individual interval between index operation and the initial revision among different hydrocephalus etiologies |
Outcome results
None listed