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Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes
INTRODUCTION: As a disorder of the brain in adults and children, traumatic brain injury (TBI) is considered the major cause of mortality and morbidity. As a serious complication of TBI, post-traumatic hydrocephalus (PTH) is commonly identified and significantly associated with neurocognitive impairm...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444705/ https://www.ncbi.nlm.nih.gov/pubmed/37330939 http://dx.doi.org/10.1007/s40120-023-00511-7 |
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author | Xu, Hao Dong, Yongfei Bao, Dejun Wei, Xiangpin Niu, Chaoshi Liu, Xinfeng |
author_facet | Xu, Hao Dong, Yongfei Bao, Dejun Wei, Xiangpin Niu, Chaoshi Liu, Xinfeng |
author_sort | Xu, Hao |
collection | PubMed |
description | INTRODUCTION: As a disorder of the brain in adults and children, traumatic brain injury (TBI) is considered the major cause of mortality and morbidity. As a serious complication of TBI, post-traumatic hydrocephalus (PTH) is commonly identified and significantly associated with neurocognitive impairment, motor dysfunction, and growth impairment. The long-term functional outcomes after shunt dependence are totally not clear. METHODS: This study included 6279 patients between 2012 and 2022. To identify the unfavorable functional outcomes and the PTH-related factors, we carried out univariable logistic regression analyses. To identify the occurrence time of PTH, we conducted the log-rank test and Kaplan–Meier analysis. RESULTS: Mean patient age was 51.03 ± 22.09 years. Of the 6279 patients with TBI, 327 developed PTH (5.2%). Several PTH development-associated factors, such as intracerebral hematoma, diabetes, longer initial hospital stay, craniotomy, low GCS (Glasgow Coma Scale), EVD (external ventricular drain), and DC (decompressive craniectomy) (p < 0.01), were identified. We also analyzed the factors of unfavorable outcomes after TBI including > 80 years, repeated operations, hypertension, EVD, tracheotomy, and epilepsy (p < 0.01). Ventriculoperitoneal shunt (VPS) itself is not an independent factor of the unfavorable outcome but shunt complication is a strong independent factor of unfavorable outcome (p < 0.05). CONCLUSION: We should emphasize the practices that can minimize the risks of shunt complications. Additionally, the rigorous radiographic and clinical surveillance will benefit those patients at high risk of developing PTH. TRIAL REGISTRATION: ClinicalTrials.gov identifier, ChiCTR2300070016. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40120-023-00511-7. |
format | Online Article Text |
id | pubmed-10444705 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-104447052023-08-24 Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes Xu, Hao Dong, Yongfei Bao, Dejun Wei, Xiangpin Niu, Chaoshi Liu, Xinfeng Neurol Ther Original Research INTRODUCTION: As a disorder of the brain in adults and children, traumatic brain injury (TBI) is considered the major cause of mortality and morbidity. As a serious complication of TBI, post-traumatic hydrocephalus (PTH) is commonly identified and significantly associated with neurocognitive impairment, motor dysfunction, and growth impairment. The long-term functional outcomes after shunt dependence are totally not clear. METHODS: This study included 6279 patients between 2012 and 2022. To identify the unfavorable functional outcomes and the PTH-related factors, we carried out univariable logistic regression analyses. To identify the occurrence time of PTH, we conducted the log-rank test and Kaplan–Meier analysis. RESULTS: Mean patient age was 51.03 ± 22.09 years. Of the 6279 patients with TBI, 327 developed PTH (5.2%). Several PTH development-associated factors, such as intracerebral hematoma, diabetes, longer initial hospital stay, craniotomy, low GCS (Glasgow Coma Scale), EVD (external ventricular drain), and DC (decompressive craniectomy) (p < 0.01), were identified. We also analyzed the factors of unfavorable outcomes after TBI including > 80 years, repeated operations, hypertension, EVD, tracheotomy, and epilepsy (p < 0.01). Ventriculoperitoneal shunt (VPS) itself is not an independent factor of the unfavorable outcome but shunt complication is a strong independent factor of unfavorable outcome (p < 0.05). CONCLUSION: We should emphasize the practices that can minimize the risks of shunt complications. Additionally, the rigorous radiographic and clinical surveillance will benefit those patients at high risk of developing PTH. TRIAL REGISTRATION: ClinicalTrials.gov identifier, ChiCTR2300070016. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40120-023-00511-7. Springer Healthcare 2023-06-18 /pmc/articles/PMC10444705/ /pubmed/37330939 http://dx.doi.org/10.1007/s40120-023-00511-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Xu, Hao Dong, Yongfei Bao, Dejun Wei, Xiangpin Niu, Chaoshi Liu, Xinfeng Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title | Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title_full | Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title_fullStr | Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title_full_unstemmed | Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title_short | Shunt-Dependent Post-Traumatic Hydrocephalus: Predictors and Long-Term Functional Outcomes |
title_sort | shunt-dependent post-traumatic hydrocephalus: predictors and long-term functional outcomes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10444705/ https://www.ncbi.nlm.nih.gov/pubmed/37330939 http://dx.doi.org/10.1007/s40120-023-00511-7 |
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