Pediatric hydrocephalus outcomes: a review

Vinchon, Matthieu; Rekate, Harold; Kulkarni, Abhaya V

doi:10.1186/2045-8118-9-18

Fluids and Barriers of the CNS

Table 2 Association between factors pertaining to the patient, treatments and medical resources (predictive variables) and surgical and clinical outcomes (dependent variables)

From: Pediatric hydrocephalus outcomes: a review

Predictive variable	Shunt failure	Shunt infection	Hydrocephalus-related mortality	Endoscopy failure	Neurological deficit	Epilepsy	Cognitive impairment	Difficulties at school	QOL	Social insertion
Young age at surgery	higher [8, 37, 61, 62]	higher [7–9, 61]	higher [50, 63]	higher [21, 64]	higher [31]	higher [31] NS [60]	higher [31, 44]	higher [44]	lower [29, 30, 37, 44]	lower [37]
Prematurity	higher [62, 65–68]	higher [7, 66–68]	higher [27] NS [67] lower [44, 50]	higher [69]	higher [27, 44, 68]	higher [39]	higher [27, 68]	higher [44] NS [9]	lower [29]	no data found
Post-meningitis hydrocephalus	Higher [56, 62, 70]	NS [7, 9]	higher [71]	higher [20] NS [72]	lower [57]	higher [30, 39, 56]	higher [4, 40, 56]	higher [5, 9, 61]	lower [4, 30]	lower [4]
ventricular hemorrhage	higher [8, 62, 70] NS [61]	higher [73] NS [7, 9]	lower [4] higher [63]	higher [20, 69]	higher [34, 57]	higher [39, 56, 57]	higher [30, 34, 44, 57]	higher [5, 61] NS [9]	lower [30] higher [4]	lower [4]
spina bifida	higher [62, 74]	higher [74] NS [7]	higher [3, 50, 58, 74]	higher [18, 23]	higher [56, 57]	lower [39, 57]	lower [36, 57]	Lower [49] higher [9]	lower [4, 30]	lower [4]
shunt obstruction	risk of recurrent revisions [8, 62, 70]	risk increases with recurrent revisions [70]	main cause [63]	higher [22, 23, 75]	higher [44] NS [57]	higher [39] NS [60]	higher [57, 76] NS [41, 47, 49]	Higher [76, 77] NS [61]	lower [29]	no data found
shunt infection	(1)	(1)	higher [9, 58]	higher [22]	higher [30]	higher [9, 39] NS [60]	higher [9, 57]	higher [9]	lower [9, 78]	no data found
endoscopy	lower [19, 24]	lower [19, 79]	lower [23] NS [73]	(1)	no data found	lower [39, 80]	NS [79]	no data found	better [73] NS [79]	no data found
epilepsy	higher in infants [60]	no data found	no data found	no data found	no data found	(1)	higher [36, 39, 56, 81]	higher [39]	lower [29, 30]	no data found
local resources	high volume of surgery: lower [12]	high volume of surgery: lower [12]	high volume: lower [12] geographic distance: higher [63]	no data found	no data found	no data found	no data found	no data found	geographic distance: lower [29]	no data found

Because they are both causes and consequences, shunt obstruction, shunt infection and epilepsy are indicated both as predictive and dependent variables.
(1): these correlations are not documented because meaningless (collinear variables); however, shunt obstruction has a documented impact on the risk of recurrent shunt failure [8, 62, 70].
The voids in this table indicate that there is space for clinical research on hydrocephalus outcome, especially on the very-long term outcome. QOL: quality of life.

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ISSN: 2045-8118

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