2019 Volume 28 Issue 4 Pages 188-196
There have been reports in countries other than Japan on ventriculoperitoneal (VP) shunting for pediatric hydrocephalus involving statistical analysis of large amounts of data accumulated from many institutions. In Japan, however, there have been few reports on statistical studies of VP shunt prognosis with clinical data from a sufficiently large number of research institutions and children’s hospitals.
We performed statistical analysis to identify significant factors associated with survival duration of VP shunts using data from 1,094 patients<18 years old collected from 12 hospitals by pediatric neurosurgeons. The survival duration in each case was determined via calculation of duration in days from implantation date to removal date, and Kaplan-Meier survival curves were constructed.
Then, we compared various factors potentially associated with survival duration and identified previous infection and implantation within the past year as being significant ; in particular, shunt implantation in infancy might significantly affect the occurrence of shunt infection. Survival duration was also found to be the least in cases with VP shunting at the first implantation and longest in those at the second. Analysis of different kinds of shunt systems showed no significant differences in the incidence of shunt malfunction and indicated the ventricular catheter as the most common malfunctioning part in the systems.
Analysis of larger amounts of data should be considered to establish indigenous guidelines for pediatric VP shunting in Japan following the Pediatric Hydrocephalus Systematic Review and Evidence-based Guidelines.
