Do new routines decrease complications after treatment of hydrocephalus in children?

Abstract

Abstract – Do new routines decrease complications after treatment of hydrocephalus in children? Degree project, Programme in Medicine, Do new routines decrease complications after treatment of hydrocephalus in children?, Thomas Buske, 2017, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden BACKGROUND: A study from 2010 showed that hydrocephalic children undergoing shunt surgery or endoscopic third ventriculostomy (ETV) in 2001-2005 at Sahlgrenska University Hospital suffered a high rate of failure of treatment, especially due to infection. Other studies have reported a significant decrease in infection after implementing a shunt protocol, therefore we introduced specific routines in 2012 for ETV/shunt surgery. AIM: This study aimed to evaluate the effect of the new protocol on shunt and ETV failure rate. Another aim was to identify risk factors for failure of treatment and failure of treatment due to infection. METHODS: A search in patient charts was done to include 59 children subject to their first shunt/ETV surgery in 2012-2016. Patients were followed until reaching failure of the hydrocephalus treatment or until 1st Jan 2017. Statistical analysis was used to compare failure rate of the patient population of this study to the population of 2001-2005. Risk factor analysis was carried out through Cox regression. RESULTS: Total failure in shunts decreased from 58% to 36% (p=0.019). Failure due to infection in shunts decreased from 17% to 9% (p=0.180). In shunts, Cox regression did not prove any factors to increase risk of failure of treatment, or risk of failure due to infection. CONCLUSIONS: This study suggest that implementation of a shunt protocol is an effective way to reduce failure of treatment.