Shunt complications and revisions in children: A retrospective single institution study

Abstract Introduction Shunt surgery in children is associated with high revision and complication rates. We investigated revision rates and postoperative complications to specify current challenges associated with pediatric shunt surgery. Methods All patients aged < 18 years admitted to St. Olavs...

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Autores principales:	Nadia Mansoor, Ole Solheim, Oddrun A. Fredriksli, Sasha Gulati
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Hydrocephalus ventriculoperitoneal shunt ventriculoatrial shunt cystoperitoneal shunt shunt complications shunt revision Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/cd1679fe250a4452ba92b29c3423fe8b
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spelling	oai:doaj.org-article:cd1679fe250a4452ba92b29c3423fe8b2021-11-25T06:06:36ZShunt complications and revisions in children: A retrospective single institution study2162-327910.1002/brb3.2390https://doaj.org/article/cd1679fe250a4452ba92b29c3423fe8b2021-11-01T00:00:00Zhttps://doi.org/10.1002/brb3.2390https://doaj.org/toc/2162-3279Abstract Introduction Shunt surgery in children is associated with high revision and complication rates. We investigated revision rates and postoperative complications to specify current challenges associated with pediatric shunt surgery. Methods All patients aged < 18 years admitted to St. Olavs University Hospital, Norway, from January 2008 through December 2017, who underwent primary shunt insertions, were reviewed. Follow‐up ranged from 1 to 10 years. Ventriculoperitoneal, cystoperitoneal, and ventriculoatrial shunts were included. All subsequent shunt revisions and 30‐day postoperative complication rates were registered. Results 81 patients underwent 206 surgeries in the study period. 47 patients (58%) required minimum one revision during follow‐up. In 14 (29.8%), the first revision was due to the misplacement of hardware. Proximal occlusion was the most common cause of revision (30.4%), followed by misplacement (18.5%) and infection (9.6%). Young age and MMC were associated with revision surgery in a univariable analysis, but were not significant in multivariable analyses. Congenital hydrocephalus was associated with infection (p = .028). In approximately 30% of procedures, complications occurred within 30 days postoperatively, the most common being revision surgery. In approximately 5% of the procedures, medical complications occurred. Conclusion Children are prone to high revision and complication rates, and in this study, misplacement of hardware and proximal occlusion were the most common. Complication rates should not be limited to revision rates only, as 30‐day complication rates indicate a significant rate of other complications as well. Multi‐targeted approaches, perhaps focusing on measures to reduce misplacement, may be key to reducing revision rates.Nadia MansoorOle SolheimOddrun A. FredriksliSasha GulatiWileyarticleHydrocephalusventriculoperitoneal shuntventriculoatrial shuntcystoperitoneal shuntshunt complicationsshunt revisionNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain and Behavior, Vol 11, Iss 11, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hydrocephalus ventriculoperitoneal shunt ventriculoatrial shunt cystoperitoneal shunt shunt complications shunt revision Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Hydrocephalus ventriculoperitoneal shunt ventriculoatrial shunt cystoperitoneal shunt shunt complications shunt revision Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Nadia Mansoor Ole Solheim Oddrun A. Fredriksli Sasha Gulati Shunt complications and revisions in children: A retrospective single institution study
description	Abstract Introduction Shunt surgery in children is associated with high revision and complication rates. We investigated revision rates and postoperative complications to specify current challenges associated with pediatric shunt surgery. Methods All patients aged < 18 years admitted to St. Olavs University Hospital, Norway, from January 2008 through December 2017, who underwent primary shunt insertions, were reviewed. Follow‐up ranged from 1 to 10 years. Ventriculoperitoneal, cystoperitoneal, and ventriculoatrial shunts were included. All subsequent shunt revisions and 30‐day postoperative complication rates were registered. Results 81 patients underwent 206 surgeries in the study period. 47 patients (58%) required minimum one revision during follow‐up. In 14 (29.8%), the first revision was due to the misplacement of hardware. Proximal occlusion was the most common cause of revision (30.4%), followed by misplacement (18.5%) and infection (9.6%). Young age and MMC were associated with revision surgery in a univariable analysis, but were not significant in multivariable analyses. Congenital hydrocephalus was associated with infection (p = .028). In approximately 30% of procedures, complications occurred within 30 days postoperatively, the most common being revision surgery. In approximately 5% of the procedures, medical complications occurred. Conclusion Children are prone to high revision and complication rates, and in this study, misplacement of hardware and proximal occlusion were the most common. Complication rates should not be limited to revision rates only, as 30‐day complication rates indicate a significant rate of other complications as well. Multi‐targeted approaches, perhaps focusing on measures to reduce misplacement, may be key to reducing revision rates.
format	article
author	Nadia Mansoor Ole Solheim Oddrun A. Fredriksli Sasha Gulati
author_facet	Nadia Mansoor Ole Solheim Oddrun A. Fredriksli Sasha Gulati
author_sort	Nadia Mansoor
title	Shunt complications and revisions in children: A retrospective single institution study
title_short	Shunt complications and revisions in children: A retrospective single institution study
title_full	Shunt complications and revisions in children: A retrospective single institution study
title_fullStr	Shunt complications and revisions in children: A retrospective single institution study
title_full_unstemmed	Shunt complications and revisions in children: A retrospective single institution study
title_sort	shunt complications and revisions in children: a retrospective single institution study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/cd1679fe250a4452ba92b29c3423fe8b
work_keys_str_mv	AT nadiamansoor shuntcomplicationsandrevisionsinchildrenaretrospectivesingleinstitutionstudy AT olesolheim shuntcomplicationsandrevisionsinchildrenaretrospectivesingleinstitutionstudy AT oddrunafredriksli shuntcomplicationsandrevisionsinchildrenaretrospectivesingleinstitutionstudy AT sashagulati shuntcomplicationsandrevisionsinchildrenaretrospectivesingleinstitutionstudy
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Shunt complications and revisions in children: A retrospective single institution study

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