Risk factors for delayed intracranial hemorrhage secondary to ventriculoperitoneal shunt: A retrospective study.

Background: Delayed intracranial hemorrhage (DICH), a potential complication of ventriculoperitoneal (VP) shunts, has been associated with high mortality, but its risk factors are still unclear.

Aim: To investigate the risk factors of DICH after VP shunts.

Methods: We compared the demographic and clinical characteristics of DICH and non-DICH adult patients with VP shunts between January 2016 and December 2020.

Results: The 159 adult VP shunt patients were divided into 2 groups according to the development of DICH: the DICH group ( = 26) and the non-DICH group ( = 133). No statistically significant difference was found in age, sex, laboratory examination characteristics or preoperative modified Rankin Scale (mRS) score between the DICH and non-DICH groups ( > 0.05); however, a history of an external ventricular drain (EVD) [ = 0.045; odds ratio (OR): 2.814; 95%CI: 1.024-7.730] and postoperative brain edema around the catheter ( < 0.01; OR: 8.397; 95%CI: 3.043-23.171) were associated with a high risk of DICH. A comparison of preoperative mRS scores between the DICH group and the non-DICH group showed no significant difference ( = 0.553), while a significant difference was found in the postoperative mRS scores at the 3-mo follow-up visit ( = 0.024).

Conclusion: A history of EVD and postoperative brain edema around the catheter are independent risk factors for DICH in VP shunt patients. DICH patients with a high mRS score are vulnerable to poor clinical outcomes.