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| Name | Class |
|---|---|
| Ministry of Science and Technology, Taiwan | OTHER_GOV |
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Programmable valve (PV) has been shown as a solution to the high revision rate in pediatric hydrocephalus patients, but it remains controversial among adults. This study is to compare the overall revision rate, revision cause, and revision-free survival between PV and non-programmable valve (NPV) in adult patients with different hydrocephalus etiologies.
Relatively high revision rates up to 32% of CSF shunting operations remained an unsolved problem for neurosurgeons. The cause of revisions were diverse, including overdrainage/underdrainage, shunting system obstruction, infection or technical skill related. Programmable valve (PV) has been shown as a solution to the high revision rate in pediatric hydrocephalus patients, but it remains controversial among adults. This study is to compare the overall revision rate, revision cause, and revision-free survival between PV and non-programmable valve (NPV) in adult patients with different hydrocephalus etiologies.
The investigators reviewed the chart of all patients with hydrocephalus receiving index ventricular CSF shunt operations conducted at a single institution in northern Taiwan from January 2017 to December 2017. Patients included in the study were followed up for at least five years. Statistical tests including independent t-test, Chi-square test and Fisher's exact test were used for comparative analysis, and Kaplan-Meier curve using log-rank test was performed to compare the revision-free survival between the PV and NPV groups
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Programmable valve(PV) group | Adult patients with hydrocephalus who received programmable ventricular CSF shunts operation. |
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| Non-programmable valve(NPV) group | Adult patients with hydrocephalus who received non-programmable ventricular CSF shunts operation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Programmable valve | Device | Programmable valve used in the study included Medtronic Strata, B-Braun ProGav, Codman Certas. |
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| Measure | Description | Time Frame |
|---|---|---|
| Initial Shunt revision rate | the ratio of the total number of patients with at least one revision to the total number of patients included in this study | since the time of index operation until the initial revision or 2022/07/31 |
| Total Shunt revision rate | the ratio of the total number of revisions to the total number of ventricular CSF shunt operations | since the time of index operation until the initial revision or 2022/07/31 |
| The cause of shunt revision | the cause of the shunt malfunction warranting revision operation | since the time of index operation until the initial revision or 2022/07/31 |
| Type of the revision operation | the detailed description of the revision operation | since the time of index operation until the initial revision or 2022/07/31 |
| Revision-free survival | the interval between index operation and the initial revision | since the time of index operation until the initial revision or 2022/07/31 |
| Measure | Description | Time Frame |
|---|---|---|
| Shunt revision-free survival among different hydrocephalus etiologies | the individual interval between index operation and the initial revision among different hydrocephalus etiologies | since the time of index operation until the initial revision or 2022/07/31 |
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Inclusion Criteria:
Exclusion Criteria:
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All adult patients who received CSF ventricular shunting operations at Chang Gung Medical Foundation, Linkou Branch, a tertiary medical center in northern Taiwan, would be included in the study.
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| Name | Affiliation | Role |
|---|---|---|
| ZHUO HAO Liu, PhD | Department of Neurosurgery Chang Gung Memorial Hospital Chang Gung Medical College and University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28648796 | Background | Li M, Wang H, Ouyang Y, Yin M, Yin X. Efficacy and safety of programmable shunt valves for hydrocephalus: A meta-analysis. Int J Surg. 2017 Aug;44:139-146. doi: 10.1016/j.ijsu.2017.06.078. Epub 2017 Jun 22. | |
| 31174190 | Background | Rinaldo L, Bhargav AG, Nesvick CL, Lanzino G, Elder BD. Effect of fixed-setting versus programmable valve on incidence of shunt revision after ventricular shunting for idiopathic normal pressure hydrocephalus. J Neurosurg. 2019 Jun 7;133(2):564-572. doi: 10.3171/2019.3.JNS183077. Print 2020 Aug 1. |
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| ID | Term |
|---|---|
| D006849 | Hydrocephalus |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| Non-programmable valve | Device | Non-programmable valve used in the study was Medtronic CSF-flow control valve. |
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| 21508873 | Background | Reddy GK, Bollam P, Shi R, Guthikonda B, Nanda A. Management of adult hydrocephalus with ventriculoperitoneal shunts: long-term single-institution experience. Neurosurgery. 2011 Oct;69(4):774-80; discussion 780-1. doi: 10.1227/NEU.0b013e31821ffa9e. |