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Table 1 Incidence of different complications and prevalence of the different types of morbidity according to literature

From: Pediatric hydrocephalus outcomes: a review

Complications and morbidity Data in literature Comment on biases
shunt obstruction number of shunt revisions per patient 2.7 at 24.2 years [4] 4.2 at 20 years [26] 2.7 at 17 years [49] duration-dependent; rates of revision also reflects the closeness of follow-up
  Event-Free Survival at 1 year 70% [8, 51] 62% [46] 80% [4] depends on the age at insertion and the number of prematures shunted
  Event-Free Survival at 10 year 35% [51], 48% [4] few data on the very long term
Endoscopy failure rate Event-Free Survival at 5 years 62% [22] 45% [23] few data on the very long term
shunt infection per surgery 0.17% [52] 7.9% [11] 8.4% [46] depends on definition criteria, selection of patients and duration of follow-up
  per patient (long term) 15.6% [4] 37.5% [37] depends on duration of follow-up
  per surgeon (range within a team) 5.2-12.2% [9] 7–9.4% [53] 6.1-11.7% [11] significant differences between surgeons [53]; NS[9, 11]
  actuarial incidence 8.5% at 1 year [8] 20.3% at 10 years [9] very few data on long-term incidence
shunt independence overall 3.2% [54] 9% [55] depends on etiology of hydrocephalus and eargeness to remove the shunt
  successful endoscopy when shunt malfunction 77% of attempts [15] 64% [14] reflects selection of patients
Mortality overall 1.22 [56] 14.6% [57] depends whether tumors are included or not
  non-tumoral mortality 8.6% [58] 13.7% [49] depends on duration of follow-up and intercurrent events in debilitated patients
  shunt-related 0 [48] 2.9% [26] 3.65% [57] depends on duration of follow-up; impact of staff and patient education
Morbidity motor handicap 30% [30] 34.2% [56] 60% [36] series with spina bifida
  low IQ 12.5% [47] 54.2% [48] selection bias for testing
  normal schooling 38% [43] 30% [36] 79% [26] depends on tolerance of schooling system
  no schooling 5.5% [4] 9% [30] 9% [36] depends on tolerance of schooling system
  visual 25% [36] 33% [59] 83% [35] depends on how thoroughly examined
  pregnancy 14.5% [4] 20.6% [37] impact of early age of shunting
  epilepsy 2%/year [60] 6.5% [4] 14% [30] 25% [57] 30% [36] 32% [39] associated with severe initial disease and poor outcome
  depression 43.2% [37] may be biased by selection (self reported morbidity)
  headache 8% [4] 44% [40] depends on age
social integration normal job (competitive labor market) 33.3% [4] 56% [5] bias linked with protracted follow-up
  sheltered job 23% [4, 26] depends on proactive welfare system
  partner 6% [5] 22% [26] 37% [37] selection bias: studies based on voluntary participation