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

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