Published online Jul 26, 2022. doi: 10.12998/wjcc.v10.i21.7302
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
Delayed intracranial hemorrhage (DICH), a potential complication of ventriculoperitoneal (VP) shunts, has been associated with high mortality, but its risk factors are still unclear.
To investigate the risk factors of DICH after VP shunts.
We compared the demographic and clinical characteristics of DICH and non-DICH adult patients with VP shunts between January 2016 and December 2020.
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).
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.
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.