Yi Zhang1, Rui Zhao1, Wei Shi1, JiCui Zheng1, Hao Li2, ZhiHua Li3. 1. Department of Neurosurgery, Children's Hospital Fudan University, 399#, Wan Yuan Road, Shanghai, 201102, China. 2. Department of Neurosurgery, Children's Hospital Fudan University, 399#, Wan Yuan Road, Shanghai, 201102, China. lihao7272@163.com. 3. Department of Neonatology, Children's Hospital Fudan University, 399#, Wan Yuan Road, Shanghai, 201102, China. lizhihua09@163.com.
Abstract
PURPOSE: To assess the therapeutic efficacy of external ventricular draining (EVD) and to predict the need for permanent shunts in infants with postinfective hydrocephalus (PIHC). METHODS: This is a retrospective study of infants diagnosed with PIHC and treated by EVD between January 2013 and December 2017 at the Children's Hospital of Fudan University. Clinical, laboratory, and imaging data were collected and analyzed to identify independent risk factors by logistic regression analyses. The predictor was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curves. RESULTS: In total, 48 patients were identified, and 31 cases (64.5%) had a permanent shunt. EVD was effective in accelerating cerebrospinal fluid purification. In the permanent shunt group, the duration of EVD was significantly longer (28.5 ± 5.2 vs 14.9 ± 3.0 P < 0.05) and the frontal and occipital horn ratio (FOHR) at 7-10 days after EVD was significantly higher (0.57 ± 0.01 vs 0.48 ± 0.01 P < 0.001). The FOHR at 7-10 days after EVD predicts the need for a permanent shunt with an area under the ROC curve of 0.818. CONCLUSION: EVD was effective for purification of CSF, whereas a permanent shunt was needed for more than half of the patients. The FOHR at 7-10 days after EVD may be a strong predictor for a permanent shunt.
PURPOSE: To assess the therapeutic efficacy of external ventricular draining (EVD) and to predict the need for permanent shunts in infants with postinfective hydrocephalus (PIHC). METHODS: This is a retrospective study of infants diagnosed with PIHC and treated by EVD between January 2013 and December 2017 at the Children's Hospital of Fudan University. Clinical, laboratory, and imaging data were collected and analyzed to identify independent risk factors by logistic regression analyses. The predictor was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curves. RESULTS: In total, 48 patients were identified, and 31 cases (64.5%) had a permanent shunt. EVD was effective in accelerating cerebrospinal fluid purification. In the permanent shunt group, the duration of EVD was significantly longer (28.5 ± 5.2 vs 14.9 ± 3.0 P < 0.05) and the frontal and occipital horn ratio (FOHR) at 7-10 days after EVD was significantly higher (0.57 ± 0.01 vs 0.48 ± 0.01 P < 0.001). The FOHR at 7-10 days after EVD predicts the need for a permanent shunt with an area under the ROC curve of 0.818. CONCLUSION:EVD was effective for purification of CSF, whereas a permanent shunt was needed for more than half of the patients. The FOHR at 7-10 days after EVD may be a strong predictor for a permanent shunt.
Entities:
Keywords:
External ventricular draining; Frontal and occipital horn ratio (FOHR); Permanent shunt; Postinfective hydrocephalus (PIHC)
Authors: James P McAllister; Michael A Williams; Marion L Walker; John R W Kestle; Norman R Relkin; Amy M Anderson; Paul H Gross; Samuel R Browd Journal: J Neurosurg Date: 2015-06-19 Impact factor: 5.115
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