Abstract
Materials and methods The authors collected computerized data for all patients subjected to a CSF shunt insertion or revision except those with brain tumours from the Patient Data Management System and the Computer Information System of the Seattle Children's Hospital from 1 January 2000 through 31 December 2008. Data collected included the patient's diagnosis, birth date, details of the operation insertion and components of revisions, valve type and location, type and timing of prophylactic antibiotic administration, time of day of the operation, duration of operation, presence of a trainee, incidence of shunt complications and white blood cell (WBC) and red blood cell counts (RBC) in the CSF obtained at the time of operation. Patients were followed for a minimum of one year post-operatively and statistical analysis was done using Vassar STATS® and MedCalc® which included Chi Square, Kaplan Meier Survival Curves and multi-variant analysis. Results A total of 1,278 operations were analyzed that incorporated 450 valve (233 PVS & 217 NPVS) implantations (166) or revisions (284) for 306 patients. Patients with a PVS that were adjusted (≥ 6 mo after implantation) demonstrated no significant difference to rate of non-valve revision (X2 p = 0.63), infection(X2 p = 0.99), or overall valve survival (KM p = 0.24) compared to patients with NPVS. Complications leading to valve replacement of the initial implantation occurred in 42% of NPVS and 45% of PVS(X2 p = 0.89). By differentiating patients by their preoperative WBC (poly ≥ 3 or mono ≥ 50) and/or RBC ≥ 30 in the CSF (as indications for inflammation), revisions of NPVS were significantly greater in valve survival rate than the PVS (p = 0.002). No significant differences existed between the two valve systems for reason of revision, location, age of patient, time of day, duration of the operation type of antibiotic used or time of administration or presence of trainee.
Highlights
Open AccessEfficacy of conventional valves compared to programmable valves in managing children & adolescents with hydrocephalus: a 450 valve retrospective study
During the past 10 years, programmable cerebrospinal fluid (CSF) shunts (PVS) have increasingly replaced conventional non-programmable shunts (NPVS)
Data collected included the patient's diagnosis, birth date, details of the operation insertion and components of revisions, valve type and location, type and timing of prophylactic antibiotic administration, time of day of the operation, duration of operation, presence of a trainee, incidence of shunt complications and white blood cell (WBC) and red blood cell counts (RBC) in the CSF obtained at the time of operation
Summary
Efficacy of conventional valves compared to programmable valves in managing children & adolescents with hydrocephalus: a 450 valve retrospective study. Address: 1Department of Paediatrics, MS: A - 7938, University of Washington, 1959 Pacific Avenue N E, Seattle Washington, 98195, USA and 2Department of Neurological Surgery, MS: W - 7, University of Washington, Seattle Washington, 98195, USA. Published: 27 November 2009 Cerebrospinal Fluid Research 2009, 6(Suppl 2):S9 doi:10.1186/1743-8454-6-S2-S9. 53rd Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
