Implementation of a Shunt Insertion Protocol and Its Effect on Institutional Shunt Infection Rates.

Area of Science:

• Neurosurgery
• Infectious Disease Prevention
• Clinical Protocol Evaluation

Background:

• Hydrocephalus management commonly uses ventriculoperitoneal shunts (VPS), but infection is a significant complication.
• The Hydrocephalus Clinical Research Network (HCRN) developed protocols to mitigate shunt infections.
• This study assessed a local adaptation of the HCRN protocol at Philippine General Hospital (PGH).

Purpose of the Study:

• To evaluate the efficacy of the PGH Shunt Protocol in reducing ventriculoperitoneal shunt infection rates.
• To identify patient characteristics, operative factors, and protocol adherence associated with shunt infection risk.

Main Methods:

• Implementation of an 11-step PGH Shunt Protocol from January to June 2023.
• Analysis of data from 69 patients undergoing shunt procedures.
• Logistic regression to assess associations between variables and shunt infection.

Main Results:

• The overall shunt infection rate was 11.6% (8/69).
• No significant associations were found between patient characteristics, operative factors, and infection risk.
• Protocol compliance was 52% (36/69), and adherence did not significantly reduce infection risk.

Conclusions:

• Suboptimal compliance (52%) precluded definitive conclusions on the PGH Shunt Protocol's efficacy.
• No specific patient or surgical factors were identified as significant predictors of shunt infection in this cohort.