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Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus.

Publication ,  Journal Article
Hung, AL; Moran, D; Vakili, S; Fialho, H; Sankey, EW; Jusué-Torres, I; Elder, BD; Goodwin, CR; Lu, J; Robison, J; Rigamonti, D
Published in: World Neurosurg
June 2016

OBJECTIVE: Few studies have focused on predictive factors of ventriculoperitoneal (VP) shunt revision in patients with idiopathic normal pressure hydrocephalus (iNPH). This study aims to determine whether comorbidities and baseline symptoms are associated with the need for shunt revision. METHODS: A retrospective review of patients with iNPH treated with VP shunts by the senior author from 1993 to 2013 was conducted. Demographics and baseline symptoms were compared between patients with and without shunt revision. The need for revision, total number of revisions, and time to first revision were examined. Statistical analysis was performed using simple logistic, linear, and Poisson regression, and a multivariate analysis was performed. RESULTS: A total of 347 patients with iNPH who received VP shunts were included. One hundred patients (28.8%) required shunt revision, with an average of 1.38 ± 0.76 revisions per patient. Mean time to revision was 19.2 ± 31.7 months. Gait and cognitive symptoms were associated with fewer revisions (incidence rate ratio, 0.45 and 0.67; P = 0.03 and 0.004, respectively). Headaches and urinary incontinence showed a greater time to revision (32.0 and 12.0 months; P = 0.014 and <0.0005, respectively). Gait instability demonstrated decreased time to revision (P < 0.0005). CONCLUSIONS: Preoperative symptoms, such as headaches, gait instability, cognitive decline, and urinary incontinence, were significantly correlated with number of revisions and time to first revision. These factors should be considered during the initial counseling of prognosis for patients with iNPH receiving VP shunts.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2016

Volume

90

Start / End Page

76 / 81

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Urinary Incontinence
  • Treatment Outcome
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Prognosis
  • Prevalence
  • Postoperative Complications
 

Citation

APA
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ICMJE
MLA
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Hung, A. L., Moran, D., Vakili, S., Fialho, H., Sankey, E. W., Jusué-Torres, I., … Rigamonti, D. (2016). Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus. World Neurosurg, 90, 76–81. https://doi.org/10.1016/j.wneu.2016.02.061
Hung, Alice L., Dane Moran, Sharif Vakili, Hugo Fialho, Eric W. Sankey, Ignacio Jusué-Torres, Benjamin D. Elder, et al. “Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus.World Neurosurg 90 (June 2016): 76–81. https://doi.org/10.1016/j.wneu.2016.02.061.
Hung AL, Moran D, Vakili S, Fialho H, Sankey EW, Jusué-Torres I, et al. Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus. World Neurosurg. 2016 Jun;90:76–81.
Hung, Alice L., et al. “Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus.World Neurosurg, vol. 90, June 2016, pp. 76–81. Pubmed, doi:10.1016/j.wneu.2016.02.061.
Hung AL, Moran D, Vakili S, Fialho H, Sankey EW, Jusué-Torres I, Elder BD, Goodwin CR, Lu J, Robison J, Rigamonti D. Predictors of Ventriculoperitoneal Shunt Revision in Patients with Idiopathic Normal Pressure Hydrocephalus. World Neurosurg. 2016 Jun;90:76–81.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2016

Volume

90

Start / End Page

76 / 81

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Urinary Incontinence
  • Treatment Outcome
  • Sex Distribution
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Prognosis
  • Prevalence
  • Postoperative Complications