Factors affecting cerebrospinal fluid shunt revision rate in children at King Khalid University Hospital
Jamjoom, A.B.; Jamjoom, Z.A.B.; Ur-Rahman, N.; Mohammed, A.A.; Neel, K.F.
Saudi Medical Journal 19(1): 15-18
1998
ISSN/ISBN: 0379-5284 PMID: 27701507 Document Number: 490226
Ventriculoperitoneal (VP) shunt is a common neurosurgical operation that is associated with a high incidence of complications necessitating revisions. Up to date, there is no data regarding the pattern and incidence of shunt complications and factors affecting shunt revision rate in children in Saudi Arabia. Methods: A retrospective review of 133 pediatric patients that underwent VP shunting at King Khalid University Hospital (KKUH) between 1990-1993 was carried. At a follow up of 3 months - 6 years (mean 25 months), 107 revision procedures were performed for the same patients making the total number of shunting operations for these patients 240. Results: Fifty-three revisions were due to shunt obstruction and 24 revisions were due to shunt infection. Our overall annual shunt revision rate was 0.39. A significantly higher annual shunt revision rate was encountered in patients aged 6 months or less in general and in premature infants with posthemorrhagic hydrocephalus in particular and in whom the surgery was carried out by the registrar. In addition, premature infants with posthemorrhagic hydrocephalus had a significantly higher incidence of shunt infection than other hydrocephalic patients. However, the shunt revision rate was not significantly affected by the type of shunt, the previous occurrence of a shunt revision and whether the first revision was for an infective or non-infective complication. Conclusions: It is recommended that VP shunts for children aged 6 months or less in general and for premature infants with posthemorrhagic hydrocephalus in particular should be carried out by the consultant. Refinement of the surgical technique is essential if shunt complications are to be minimized.