Related Experiment Video
Updated: Apr 16, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Factors affecting ventriculoperitoneal shunt survival in adult patients
Farid Khan1, Abdul Rehman2, Muhammad S Shamim1
1Department of Surgery, The Aga Khan University, Stadium Road, Karachi, Sindh, Pakistan.
Insights
Ventriculoperitoneal shunts are common for hydrocephalus but have complications. Adult patients with higher age, longer hospital stays, lower GCS scores, or brain tumor excision face higher risks of early shunt malfunction.
Area of Science:
- Neurosurgery
- Neurology
- Medical Devices
Background:
- Ventriculoperitoneal (VP) shunts are primary treatment for hydrocephalus, yet complications are frequent.
- Most VP shunt malfunction studies focus on pediatric populations, leaving adult data limited.
- This study examines 11-year VP shunt outcomes in adult hydrocephalus patients, particularly in a developing country context.
Purpose of the Study:
- To report the 11-year experience with VP shunt insertion in adult hydrocephalus patients.
- To identify factors influencing shunt survival and malfunction in this demographic.
- To assess VP shunt performance in a resource-limited setting.
Main Methods:
- Retrospective analysis of adult patients undergoing VP shunt placement from 2001-2011.
- Kaplan-Meier curves to analyze time to first shunt malfunction.
- Log-rank (Cox-Mantel) tests to identify predictors of shunt survival.
Main Results:
- 227 adult patients (18-85 years) were analyzed; common etiologies included post-cranial surgery, brain tumors, normal pressure hydrocephalus, and intracranial hemorrhage.
- Overall shunt malfunction rate was 15.4%, with a median time to failure of 120 days.
- Hydrocephalus etiology (P=0.030) significantly impacted malfunction. Early failure correlated with increased age (P<0.001), prolonged hospital stay (P<0.001), low Glasgow Coma Scale (GCS) score (P=0.010), brain tumor excision (P=0.008), and extra-ventricular drains (P=0.033).
Conclusions:
- Increased age, prolonged hospital stay, GCS < 13, presence of extra-ventricular drains, and brain tumor excision are associated with higher risks of early VP shunt malfunction in adults.
- These findings highlight specific risk factors for VP shunt failure in adult hydrocephalus patients.
- Understanding these predictors can aid in optimizing patient selection and management strategies.
Background:
Ventriculoperitoneal (VP) shunt insertion remains the mainstay of treatment for hydrocephalus despite a high rate of complications. The predictors of shunt malfunction have been studied mostly in pediatric patients. In this study, we report our 11-year experience with VP shunts in adult patients with hydrocephalus. We also assess the various factors affecting shunt survival in a developing country setting.
Methods:
A retrospective chart analysis was conducted for all adult patients who had undergone shunt placement between the years 2001 and 2011. Kaplan-Meier curves were used to determine the duration from shunt placement to first malfunction and log-rank (Cox-Mantel) tests were used to determine the factors affecting shunt survival.
Results:
A total of 227 patients aged 18-85 years (mean: 45.8 years) were included in the study. The top four etiologies of hydrocephalus included post-cranial surgery (23.3%), brain tumor or cyst (22.9%), normal pressure hydrocephalus (15%), and intracranial hemorrhage (13.7%). The overall incidence of shunt malfunction was 15.4% with the median time to first shunt failure being 120 days. Etiology of hydrocephalus (P = 0.030) had a significant association with the development of shunt malfunction. Early shunt failure was associated with age (P < 0.001), duration of hospital stay (P < 0.001), Glasgow Coma Scale (GCS) score less than 13 (P = 0.010), excision of brain tumors (P = 0.008), and placement of extra-ventricular drains (P = 0.033).
Conclusions:
Patients with increased age, prolonged hospital stay, GCS score of less than 13, extra-ventricular drains in situ, or excision of brain tumors were more likely to experience early shunt malfunction.
More Related Videos
06:04Author Spotlight: Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model
Published on: June 9, 2023
05:18Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026