TY - JOUR

T1 - Ventriculoperitoneal shunt outcomes among infants

AU - Maruyama, Hidehiko

AU - Nakata, Yusei

AU - Kanazawa, Akane

AU - Watanabe, Hirokazu

AU - Shigemitsu, Yusuke

AU - Iwasaki, Yuka

AU - Tokorodani, Chiho

AU - Miyazawa, Mari

AU - Nishiuchi, Ritsuo

AU - Kikkawa, Kiyoshi

N1 - Publisher Copyright:
© 2015 by Okayama University Medical School.

PY - 2015

Y1 - 2015

N2 - Ventriculoperitoneal shunts (VPSs) are used for the treatment of hydrocephalus. Here we analyzed the outcomes of VPS placements in 24 infants to determine the risk factors for shunt failure. The infants had undergone the initial VPS operation in our hospital between March 2005 and December 2013. They were observed until the end of January 2014. We obtained Kaplan-Meier curves and performed a multivariate Cox regression analysis of shunt failure. Of the 24 cases, the median (range) values for gestational age, birth weight, and birth head circumference (HC) were 37 (27-39) wks, 2,736 (686-3,788) g, and 35.3 (23.0-45.3) cm, respectively. The total number of shunt procedures was 45. Shunt failure rates were 0.51/shunt and 0.0053/shunt/year. Shunt infection rates were 0.13/shunt and 0.0014/shunt/year. The Kaplan-Meier analysis revealed an increased risk for shunt failure in infants < 1 month old or in the HC > 90%tile. The Cox regression analysis yielded hazard ratios (HRs) of 2.93 (95% confidence interval (CI), 0.96-10.95, p=0.059) for age < 1 month, and 4.46 (95%CI:1.20-28.91, p=0.023) for the HC > 90%tile. The multivariate Cox regression analysis showed adjusted HRs of 17.56 (95%CI:2.69-202.8, p=0.001) for age < 1 month, and 2.95 (95%CI:0.52-24.84, p=0.228) for the HC > 90%tile. Our findings thus revealed that the risk factors for shunt failure in infants include age < 1 month at the initial VPS placement.

AB - Ventriculoperitoneal shunts (VPSs) are used for the treatment of hydrocephalus. Here we analyzed the outcomes of VPS placements in 24 infants to determine the risk factors for shunt failure. The infants had undergone the initial VPS operation in our hospital between March 2005 and December 2013. They were observed until the end of January 2014. We obtained Kaplan-Meier curves and performed a multivariate Cox regression analysis of shunt failure. Of the 24 cases, the median (range) values for gestational age, birth weight, and birth head circumference (HC) were 37 (27-39) wks, 2,736 (686-3,788) g, and 35.3 (23.0-45.3) cm, respectively. The total number of shunt procedures was 45. Shunt failure rates were 0.51/shunt and 0.0053/shunt/year. Shunt infection rates were 0.13/shunt and 0.0014/shunt/year. The Kaplan-Meier analysis revealed an increased risk for shunt failure in infants < 1 month old or in the HC > 90%tile. The Cox regression analysis yielded hazard ratios (HRs) of 2.93 (95% confidence interval (CI), 0.96-10.95, p=0.059) for age < 1 month, and 4.46 (95%CI:1.20-28.91, p=0.023) for the HC > 90%tile. The multivariate Cox regression analysis showed adjusted HRs of 17.56 (95%CI:2.69-202.8, p=0.001) for age < 1 month, and 2.95 (95%CI:0.52-24.84, p=0.228) for the HC > 90%tile. Our findings thus revealed that the risk factors for shunt failure in infants include age < 1 month at the initial VPS placement.

KW - Head circumference

KW - Shunt failure

KW - Shunt infection

KW - Ventriculoperitoneal shunt

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M3 - Article

C2 - 25899630

AN - SCOPUS:84946174452

VL - 69

SP - 87

EP - 93

JO - Acta Medica Okayama

JF - Acta Medica Okayama

SN - 0386-300X

IS - 2

ER -