Does the cerebrospinal fluid protein concentration increase the risk of shunt complications?

A prospective study was performed to determine whether the popular opinion that a high CSF protein concentration increases the risk of shunt complications is true. Ninety-five patients were enrolled into the study and they had 116 shunt operations over 15 months. It was considered that the CSF protein content might influence the development of complications that occurred within 2 months of surgery. Shunt complications occurred following 24.6% of operations within this period. This included 12 infections, 13 obstructions and three cases of overdrainage. The distribution of complications, compared to CSF protein content, was non-significant on a chi 2-test (p > 0.5). The total protein content of each of the complication groups was also analysed using the Mann-Whitney U-test and the differences were non-significant for the infection (0.1 > p > 0.05) and obstruction groups (0.5 > p > 0.1). It is concluded that an elevated CSF protein content does not increase the risk of shunt complications, and that there is no reason why shunting should be delayed in patients with a high CSF protein content.