Breimer G E, Sival D A, Brusse-Keizer M G J, Hoving E W
Department of Neurosurgery, University Medical Centre Groningen, Hanzeplein 1, PO Box 30 001, 9700 RB Groningen, the Netherlands.
Childs Nerv Syst. 2013 Aug;29(8):1305-11. doi: 10.1007/s00381-013-2122-8. Epub 2013 May 5.
This study aims to provide external validation of the "Endoscopic Third Ventriculostomy Success Score (ETVSS)" for both short-term and long-term predictive adequacy.
Between 1998 and 2007, we collected clinical follow-up data (after 6 and 36 months) of all 104 hydrocephalic children (<18 years of age) treated by endoscopic third ventriculostomy (ETV) in our hospital. Predictive adequacy of ETVSS for 6- and 36-month periods was tested by means of an unpaired t test, Hosmer-Lemeshow "goodness-of- fit" test, and area under the receiver operating characteristic curve.
Mean follow-up was 73.4 months. For both the short-term (6 months) and the long-term (36 months) periods, the mean predicted probability of ETV for the patients with successful ETV treatment was significantly higher than in the patients with failed ETV treatment. The areas under the curve for the short- and long-term periods were, respectively, 0.82 (95% CI 0.71-0.92) and 0.73 (95% CI 0.62-0.84). For patients with moderate ETVSS (50-70), the median age at first ETV was significantly higher for patients with successful ETV for both short- and long-term periods.
In hydrocephalic children, the ETVSS is a useful tool for prediction of outcome after ETV treatment. The ETVSS is more adequate in predicting short-term than long-term success. In our population, it is suggested that success rate for patients with moderate ETVSS could be improved if more weight is attributed to age at first ETV.
本研究旨在对“内镜下第三脑室造瘘术成功评分（ETVSS）”的短期和长期预测准确性进行外部验证。
1998年至2007年期间，我们收集了我院接受内镜下第三脑室造瘘术（ETV）治疗的所有104例脑积水患儿（<18岁）的临床随访数据（6个月和36个月后）。通过非配对t检验、Hosmer-Lemeshow“拟合优度”检验以及受试者操作特征曲线下面积，对ETVSS在6个月和36个月期间的预测准确性进行了测试。
平均随访时间为73.4个月。对于短期（6个月）和长期（36个月），ETV治疗成功的患者的ETV平均预测概率显著高于ETV治疗失败的患者。短期和长期的曲线下面积分别为0.82（95%CI 0.71-0.92）和0.73（95%CI 0.62-0.84）。对于ETVSS为中等（50-70）的患者，短期和长期ETV治疗成功的患者首次ETV时的中位年龄显著更高。
在脑积水患儿中，ETVSS是预测ETV治疗后结局的有用工具。ETVSS在预测短期成功方面比长期成功更充分。在我们的研究人群中，建议如果更多地考虑首次ETV时的年龄，中等ETVSS患者的成功率可能会提高。
