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Published on: January 27, 2023
Barometric pressure variability and shunt-related hospital encounters in the pediatric population: a retrospective
Rebecca White1,2, April Gormon3, Duc T Nguyen4
1Division of Pediatric Neurosurgery, Department of Surgery, Texas Children's Hospital, Houston, TX, USA. rebecca.white@bcm.edu.
Purpose:
This study's objective was to investigate barometric pressure changes that are most strongly associated with symptom exacerbations in shunted hydrocephalus patients. To achieve this, we conducted in-depth analysis of hospital encounter data and examined their correlation with variations in sea level pressure (SLP). Ultimately, our findings may inform hydrocephalus management strategies by identifying potential environmental triggers, reducing unnecessary hospital visits, and guiding the future design of CSF diversion technologies that are more responsive to external conditions.
Methods:
We conducted a retrospective analysis of the daily hydrocephalus encounters census of a tertiary children's hospital and compared it with weather parameters, including fluctuations in SLP as measured in 8-h intervals, maximum daily rate of change, daily minimum SLP, and daily mean SLP. Data was analyzed in a univariate and multivariable Poisson generalized linear models, and census was compared to weather fluctuations on the day of encounter, the following day, and 2 days afterward.
Results:
In univariable analysis, hydrocephalus encounters were associated with the daily maximum rate of change, daily maximum SLP, daily minimum SLP, and daily mean SLP. These associations maintained 1 day and 2 days after the hospital encounters. In multivariate analysis, the daily maximum SLP and daily minimum SLP were associated with patient encounters both 1 and 2 days after the analyzed census date. Associations were also observed between daily minimal SLP, daily maximum SLP, and maximum daily 8-h SLP.
Conclusion:
This study documents an association between fluctuations in atmospheric pressure and daily hydrocephalus census at a single tertiary medical center. Weather-related influences should be considered when evaluating shunt malfunction in patients with chronic shunted hydrocephalus.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.