Floreine-Jemima Joseph1, Joseph Bernard2, Sylvio Augustin3. 1. Department of Neurology, University Notre Dame of Haiti, School of Medicine, Port-au-Prince, Haiti. Electronic address: floreinejoseph@yahoo.fr. 2. Department of Infectiology, University Notre Dame of Haiti, School of Medicine, Port-au-Prince, Haiti. 3. Department of Surgery, University Notre Dame of Haiti, School of Medicine, Port-au-Prince, Haiti.
Abstract
OBJECTIVE: Complications worsen the prognosis of hydrocephalic children who undergo surgery. The main objective of this study was to determine factors associated with postoperative complications in Haitian infants with hydrocephaly. METHODS: This was a cross-sectional study conducted on hydrocephalic infants diagnosed in a Haitian hospital from 2011 to 2013. Records were consulted to gather key variables that were evaluated in relation to the occurrence of postoperative complications. Any variable whose P value was less than 0.05 for the Mantel-Haenszel χ2 test was considered a factor associated with postoperative complications. RESULTS: The prevalence of hydrocephalus in our sample was 6.6%. Of the 131 cases of hydrocephalus surveyed, 75 were selected. The sex ratio was 1.02, and the age group from 1 to 6 months old was the most affected (52% of cases). The increase in head circumference (96% of cases) was the most common clinical sign. A total of 70.7% of the infants underwent imaging work-up, and 26.7% had central nervous system malformations. A total of 84% received surgical treatment, and one third of the operated infants presented with complications, the most common being infection (8%). Postoperative mortality was 6.7%, and 40% of operated infants had no postoperative care after medical discharge. Ventriculoperitoneal shunt was more significantly associated with complications than endoscopic third ventriculostomy (odds ratio 3.25, P = 0.03). CONCLUSIONS: Hydrocephalus in Haitian infants is diagnosed late and inadequately investigated, treated, and monitored. Ventriculoperitoneal shunts are significantly related to more postoperative complications than endoscopic third ventriculostomy.
OBJECTIVE: Complications worsen the prognosis of hydrocephalic children who undergo surgery. The main objective of this study was to determine factors associated with postoperative complications in Haitian infants with hydrocephaly. METHODS: This was a cross-sectional study conducted on hydrocephalic infants diagnosed in a Haitian hospital from 2011 to 2013. Records were consulted to gather key variables that were evaluated in relation to the occurrence of postoperative complications. Any variable whose P value was less than 0.05 for the Mantel-Haenszel χ2 test was considered a factor associated with postoperative complications. RESULTS: The prevalence of hydrocephalus in our sample was 6.6%. Of the 131 cases of hydrocephalus surveyed, 75 were selected. The sex ratio was 1.02, and the age group from 1 to 6 months old was the most affected (52% of cases). The increase in head circumference (96% of cases) was the most common clinical sign. A total of 70.7% of the infants underwent imaging work-up, and 26.7% had central nervous system malformations. A total of 84% received surgical treatment, and one third of the operated infants presented with complications, the most common being infection (8%). Postoperative mortality was 6.7%, and 40% of operated infants had no postoperative care after medical discharge. Ventriculoperitoneal shunt was more significantly associated with complications than endoscopic third ventriculostomy (odds ratio 3.25, P = 0.03). CONCLUSIONS:Hydrocephalus in Haitian infants is diagnosed late and inadequately investigated, treated, and monitored. Ventriculoperitoneal shunts are significantly related to more postoperative complications than endoscopic third ventriculostomy.