Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2022; 10(21): 7302-7313
Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7302
Risk factors for delayed intracranial hemorrhage secondary to ventriculoperitoneal shunt: A retrospective study
Jun-Chen Chen, Shou-Xing Duan, Ze-Bin Xue, Sen-Yuan Yang, Yong Li, Run-Long Lai, Dian-Hui Tan
Jun-Chen Chen, Ze-Bin Xue, Sen-Yuan Yang, Yong Li, Run-Long Lai, Dian-Hui Tan, Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Shou-Xing Duan, Department of Pediatric Surgery, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China
Shou-Xing Duan, Department of Pediatric Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, Guangdong Province, China
Author contributions: Chen JC was considered as first author; Chen JC, Xue ZB, Yang SY, Li Y, Lai RL and Tan DH participated in the patient treatment; Chen JC, Xue ZB and Yang SY collected the clinical data and performed the literature; Chen JC and Duan SX wrote the manuscript; Tan DH helped to design and revise the paper.
Supported by Shantou Medical Healthcare Science and Technology Program, No. [2019]70; Natural Science Foundation of Guangdong Province of China, No. 2022A1515010407; and Guangdong Provincial Science and Technology Fund ("major special project + Task list") for high-level hospital construction, No. STKJ2021119.
Institutional review board statement: This retrospective study was reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Shantou University Medical College, No. 2019034.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dian-Hui Tan, MD, Doctor, Department of Neurosurgery, First Affiliated Hospital of Shantou University Medical College, No. 57 Changping Road, Shantou 515041, Guangdong Province, China. tandianhui@163.com
Received: November 13, 2021
Peer-review started: November 13, 2021
First decision: April 7, 2022
Revised: April 17, 2022
Accepted: May 26, 2022
Article in press: May 26, 2022
Published online: July 26, 2022
Processing time: 239 Days and 20.5 Hours
Abstract
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 (n = 26) and the non-DICH group (n = 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 (P > 0.05); however, a history of an external ventricular drain (EVD) [P = 0.045; odds ratio (OR): 2.814; 95%CI: 1.024-7.730] and postoperative brain edema around the catheter (P < 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 (P = 0.553), while a significant difference was found in the postoperative mRS scores at the 3-mo follow-up visit (P = 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.

Keywords: Delayed intracranial hemorrhage, Ventriculoperitoneal shunt, Hydrocephalus, Risk factor, Retrospective study

Core Tip: A restrospective study of 109 patients after ventriculoperitoneal shunts indicates that a history of external ventricular drain and postoperative brain edema around the catheter are independent risk factors for delayed intracrainal hemorrhage (DICH). The DICH patients are vulnerable to poor clinical outcomes with a high modified Rankin Scale score.