The Rate of Complications after Ventriculoperitoneal Shunt Surgery.

TitleThe Rate of Complications after Ventriculoperitoneal Shunt Surgery.
Publication TypeJournal Article
Year of Publication2017
AuthorsMerkler AE, Ch'ang J, Parker WE, Murthy SB, Kamel H
JournalWorld Neurosurg
Date Published2017 Feb
KeywordsBrain Abscess, Central Nervous System Bacterial Infections, Female, Florida, Humans, Hydrocephalus, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Ventriculoperitoneal Shunt

BACKGROUND: Although ventriculoperitoneal shunt (VPS) surgery is the most frequent surgical treatment for patients with hydrocephalus, modern rates of complications in adults are uncertain.

METHODS: We performed a retrospective cohort study of adult patients hospitalized at the time of their first recorded procedure code for VPS surgery between 2005 and 2012 at nonfederal acute care hospitals in California, Florida, and New York. We excluded patients who during the index hospitalization for VPS surgery had concomitant codes for VPS revision, central nervous system (CNS) infection, or died during the index hospitalization. Patients were followed for the primary outcome of a VPS complication, defined as the composite of CNS infection or VPS revision. Survival statistics were used to calculateĀ the cumulative rate and incidence rate of VPS complications.

RESULTS: A total of 17,035 patients underwent VPS surgery. During a mean follow-up of 3.9 (Ā± 1.8) years, at least 1 VPS complication occurred in 23.8% (95% confidence interval [CI], 22.9%-24.7%) of patients. The cumulative rate of CNS infection was 6.1% (95% CI, 5.7%-6.5%) and of VPS revision 22.0% (95% CI, 21.1%-22.9%). Most complications occurred within the first year of hospitalization for VPS surgery. Complication rates were 21.3 (95% CI, 20.6-22.1) complications per 100 patients per year in the first year after VPS surgery, 5.7 (95% CI, 5.3-6.1) in the second year after VPS surgery, and 2.5 (95% CI, 2.1-3.0) in the fifth year after VPS surgery.

CONCLUSIONS: Complications are not infrequent after VPS surgery; however, most complications appear to be clustered in the first year after VPS insertion.

Alternate JournalWorld Neurosurg
PubMed ID27826086
PubMed Central IDPMC5326595
Grant ListK23 NS082367 / NS / NINDS NIH HHS / United States