Ventriculoperitoneal shunting obstruction: a multicentre clinical audit for cerebrospinal fluid parameters and its prediction role

• Published in: Neurological sciences 2024-07, Vol.45 (7), p.3495-3501
• Main Authors: Xu, Hao, He, Jiawei, Chen, Shouren, Huang, Caiquan, Zhao, Kai, Zhang, Shaolin, Wang, Anshuo, Liu, Xinfeng
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cerebrospinal fluid; China - epidemiology; Clinical Trial article; Equipment Failure; Female; Glucose; Hospitals; Humans; Hydrocephalus; Hydrocephalus - cerebrospinal fluid; Hydrocephalus - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosurgery; Patients; Proteins; Psychiatry; Retrospective Studies; Risk factors; Shunts; Surgery; Ventriculoperitoneal shunt; Ventriculoperitoneal Shunt - adverse effects
• ISSN: 1590-1874; 1590-3478; 1590-3478
• DOI: 10.1007/s10072-024-07551-3

Background Shunt obstruction is a type of ventriculoperitoneal shunt (VPS) failure. Whether changes in cerebrospinal fluid (CSF) parameters can influence shunt outcomes or not is debatable. Methods In this study, we retrospectively included adult hydrocephalus patients who received VPS from 6 general hospitals in different provinces of China from November 2013 to September 2021. The inclusion criteria: Patients with hydrocephalus of all etiologies underwent shunt surgery from 6 general hospitals in different provinces of China were included in the study. The exclusion criteria: 1.Patients under the age of 18; 2.Patients who had previous shunt surgery; 3. Shunt failure from other factors; 4.Patients died from other causes; 5. Patients with incomplete data. The CSF of shunt patients had been analyzed at the time of shunt insertion. The CSF samples were collected and analyzed when the shunt was implanted. The relationship between CSF parameters and the incidence rate of shunt obstruction in one year was analyzed. Results A total of 717 eligible patients from 6 hospitals were included, of whom 59(8.23%) experienced obstruction. Multivariate logistic regression analysis identified that protein level(odds ratio [OR] 1.161, 95% CI 1.005 ~ 1.341, p  = 0.043), decreased glucose level( 0.45 g/L) (odds ratio 3.653, 95% confidence interval 1.931 ~ 6.910, p  = 0.001)were independent risk factors of shunt obstruction. Conclusion This study suggested that increased protein level (> 0.45 g/L) and decreased glucose level (