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Published on: February 19, 2021
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TROPHY registry - status report
U W Thomale1, C Auer2, P Spennato3
1Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353, Berlin, Germany. uthomale@charite.de.
Summary
The TROPHY registry shows varied surgical approaches for neonatal hydrocephalus. Neuroendoscopic lavage (NEL) use increased, while external ventricular drainage (EVD) decreased, indicating evolving treatment strategies for neonatal post-hemorrhagic hydrocephalus (nPHH).
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Clinical Data Registries
Background:
- Neonatal intraventricular hemorrhage (IVH) frequently leads to hydrocephalus (nPHH).
- Surgical management of nPHH involves diverse techniques with varying adoption rates globally.
- Standardized data collection is crucial for developing evidence-based guidelines.
Purpose of the Study:
- To establish the TROPHY international registry for prospective data collection on surgical management of nPHH.
- To compare the efficacy and utilization of different hydrocephalus treatment techniques.
- To report initial findings on the standard of care survey from participating centers.
Main Methods:
- A survey of standard treatment protocols was conducted among 56 registered centers.
- Data on interventions for nPHH over two years (Y1 and Y2) were collected.
- Patient data from 110 infants treated between September 2018 and February 2021 were analyzed.
Main Results:
- Fewer external ventricular drains (EVDs) were used (Y1 55% to Y2 46%), while neuroendoscopic lavage (NEL) use increased (Y1 39% to Y2 52%).
- Ventricular access devices (VADs) and ventricular subgaleal shunts (VSGS) showed consistent usage rates.
- A majority of centers employed multiple techniques (43% used ≥2), with NEL being the most common treatment for enrolled patients (43%).
Conclusions:
- Surgical management strategies for nPHH are diverse across international centers.
- The TROPHY registry is actively recruiting patients, promising further insights.
- Future publications will detail comprehensive evaluations based on the registry protocol.
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