Article
Influence of age and etiology on shunt survival in infants
Der Einfluss von Alter und Ätiologie des Hydrozephalus auf das Shunt-Überleben bei Kindern im ersten Lebensjahr
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Published: | May 8, 2006 |
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Objective: Aim of this study is to determine the influence of age at surgery and etiology of hydrocephalus on shunt survival in our infant patient population.
Methods: We retrospectively evaluated 95 infants (45 male) who had undergone shunt placement between 1991 and 2003. Age at time of surgery was 1 to 362 days (mean 77, median 69). The follow-up was 12 months to 13 years. Etiology included: prematurity and IVH (n=45), myelomeningocele (n=22), meningitis (n=4), DW (n=3), AS (n=2), other etiologies (n=10), unclear (n=9).
Results: Median shunt survival in patients operated between days 1 – 90 was 253 days, in patients operated between days 91 – 180 it was 428 days and in patients operated between days 181 and 365 it was 829 days. Median shunt survival in patients with prematurity and IVH was 365 days and in patients with myelomeningocele 130 days. All other etiologies were too rare to allow comparison. Patients who had undergone temporary CSF diverting procedures prior to shunt placement (EVD, subcutaneous reservoir) had a median shunt survival of 303 days compared to 401 days in patients with no prior surgery.
Conclusions: Age and etiology determine shunt survival in infants. We use this information when discussing prognosis and follow-up with parents and pediatricians. The rationale of utilizing temporary CSF diversion needs further discussion and careful evaluation in each patient. The obtained numbers will also be useful for discussion of the indication ETV vs. Shunt in infants.