Background: CSF diversion with shunt placement is frequently associated with need for later revisions as well as surgical complications. We sought to review revision and complication rates following ventriculoperitoneal, ventriculoatrial and cystoperitoneal shunt placement in adult patients, and to identify potential risk factors for revision surgery and postoperative complications.
Method: Included patients were adults (≥ 18 years) who underwent primary shunt insertion at St. Olavs Hospital in Trondheim, Norway, from 2008 through 2017. The electronic medical records and diagnostic imaging from all hospitals in our catchment area were retrospectively reviewed. Follow-up ranged from 1 to 11 years. Complications were graded according to the Landriel Ibañez classification system.
Results: Of the 227 patients included, 47 patients (20.7%) required revision surgery during the follow-up. In total, 90 revision surgeries were performed during follow-up. The most common cause for the first revision was infection (5.7%) and for all revisions proximal occlusion (30.0%). A total of 103 patients (45.4%) experienced ≥ 1 complication(s). Mild to moderate complications (grade I and II) were detected in 35.0% of all procedures. Severe or fatal complications (grade III and IV) were observed in 8.2% of all procedures. Urinary tract infections and pneumonia were common postoperatively (13.9% and 7.3%, respectively), and the most common IIb complication was shunt misplacement (proximally or distally). Two out of fourteen deaths within 30 days were directly associated with surgery. We did not find that aetiology/indication, age or gender influenced the occurrence of revision surgery or a grade III or IV complication.
Conclusions: Shunt surgery continues to be a challenge both in terms of revision rates and procedure-related complications. However, the prediction of patients at risk remains difficult. A multidimensional focus is probably needed to reduce risks.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815545 | PMC |
| http://dx.doi.org/10.1007/s00701-020-04526-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Repositioning the Posterior Septal Angle in Rhinoplasty: Methods and Outcomes.
Laryngoscope
December 2024
Beckman Laser Institute & Medical Clinic, University of California - Irvine, Irvine, California, U.S.A.
Objective: Repositioning and fixation of the posterior septal angle (PSA) relative to the anterior nasal spine (ANS) is a well-known maneuver performed during rhinoplasty. Suture techniques through the periosteum along with transosseous drilling through the spine are the two most common fixation methods. We report on how nasal airway patency varies as a function of technique and patient demographic factors.
View Article and Find Full Text PDFPredicting complications in elderly patients undergoing oral cancer resection with free flap reconstruction in China: a retrospective cohort study using the modified Frailty Index and Prognostic Nutritional Index.
BMJ Open
December 2024
Department of Anesthesiology, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China
Objectives: This study aimed to evaluate the predictive abilities of the 5-item modified Frailty Index (5-mFI), Prognostic Nutrition Index (PNI), and their combination in older adult patients undergoing oral cancer resection and free flap reconstruction.
Design: Retrospective cohort study.
Setting: Secondary care involving multiple centres treating older adult patients for oral cancer.
Impact of Surgical Timing on Postoperative Complications Following Open Reduction Internal Fixation of Mandibular Fractures.
J Craniofac Surg
October 2024
Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital.
Purpose: The mandible is the second most fractured facial bone. The timing of open reduction internal fixation (ORIF) has been a subject of debate for decades. The authors sought to investigate the association between the timing of ORIF and the incidence of postoperative complications.
View Article and Find Full Text PDFMaintaining stability at the lumbosacral-pelvic region in adult spinal deformity surgery without sacroiliac joint fusion: are 4 pelvic screws superior to 2 pelvic screws?
J Neurosurg Spine
December 2024
1Department of Orthopaedic Surgery, The Och Spine Hospital/Columbia University Irving Medical Center, New York, New York.
Objective: The objective of this study was to compare a multiple pelvic screw fixation strategy (dual bilateral 4 pelvic screw fixation [4PvS]) with the use of single bilateral 2 pelvic screw fixation (2PvS), with the aim of addressing lumbosacral junction stability.
Methods: This analysis is a single-center, retrospective review of ASD patients treated between 2015 and 2021. All patients had a minimum 2-year follow-up and spinal fusion to the sacrum without sacroiliac fusion and met at least one radiographic and procedural criterion: pelvic incidence-lumbar lordosis ≥ 20°, T1 pelvic angle ≥ 20°, sagittal vertical axis ≥ 7.
Metal-backed versus all-poly tibia in the original cartier unicompartmental knee arthroplasty: outcomes and survivorship at long-term follow-up.
Arch Orthop Trauma Surg
December 2024
Sezione di Chirurgia Protesica ad Indirizzo Robotico Unità di Traumatologia dello Sport, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Purpose: Unicompartmental knee arthroplasty (UKA) is a viable option for localized osteoarthritis (OA) or avascular osteonecrosis with several advantages over total knee arthroplasty (TKA). UKA implants may feature a tibial component either all-polyethylene (AP) or metal-backed (MB). This study aims to retrospectively compare the clinical outcomes and survivorship of 74 UKAs over 16 years, focusing on comparing the results and survivorship of MB versus AP tibial tray.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!