Survival status and determinant factors of mortality among pediatric patients who underwent ventriculoperitoneal shunting surgery for hydrocephalus in Ethiopia.

Abstract

Background: Ventriculoperitoneal (VP) shunting is one of the most common neurosurgical procedures for treating hydrocephalus. This study aimed to assess the Survival status and determinant factors of pediatric patients who underwent ventriculoperitoneal shunting for hydrocephalus.

Methods: A multicenter institutional-based retrospective cohort study was employed by reviewing medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus from 1/12/2015 to 30/02/2023 and the medical chart records review was employed from 1/03/2023 to 30/03/2023. Data were extracted using a pre-tested, structured questionnaire. The Cox proportional hazard model was used to identify determinants of pediatric patient survival, where the hazard ratio, p-values, and 95% CI for adjusted hazard ratio were used to test significance and interpret the results. A p-value of < 0.05 was considered statistically significant.

Results: Seven hundred sixty-nine medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus were selected and reviewed with a response rate of 87.89%. The median survival time of pediatric patients after surgery was 15 months. On the multivariable Cox proportional hazard model, ultrasound image (AHR: 4.257, 95% CI: 2.07-8.74), emergency type of surgery (AHR: 2.180, 95% CI: 1.20-3.95), additional procedures other than shunting (AHR: 2.089, 95% CI: 1.05-4.16), duration of stay (> 7 days) (AHR: 4.014, 95% CI: 1.28-12.57), shunt failure (AHR: 4.163, 95% CI: 2.32-7.47), and clinical follow-up (AHR: 2.606, 95% CI: 1.31-5.17) were found to be determinants factors of survival status the patients.

Conclusion: The survival time to death was 15 months, and the mortality rate for shunting surgery for hydrocephalus was 24.58%. In this study, emergency type of surgery, additional procedures other than shunt, duration of stay (> 7 days), shunt failure, and no hospital follow-up were factors associated with the mortality of the patients.