正常压力脑积水手术后的严重不良事件。
Serious adverse events following Normal Pressure Hydrocephalus surgery.
作者信息
Kotagal Vikas, Walkowiak Elizabeth, Heth Jason A
机构信息
Department of Neurology, University of Michigan, United States; Veterans Affairs Ann Arbor Health System (VAAAHS), Ann Arbor, MI, United States.
Department of Neurosurgery University of Michigan, United States.
出版信息
Clin Neurol Neurosurg. 2018 Jul;170:113-115. doi: 10.1016/j.clineuro.2018.05.008. Epub 2018 May 15.
OBJECTIVE
Recent Normal Pressure Hydrocephalus (NPH) practice guidelines describe a serious adverse event (SAE) rate following surgery of 11%.
PATIENTS & METHODS: We conducted a retrospective review of 162 consecutive patients who have undergone work-up at our center's multidisciplinary NPH clinic over a 47 month time period (2/2014-12/2017). Of these, 22 ultimately underwent neurosurgical ventricular shunt surgery as treatment for NPH. Clinical records were reviewed for SAEs categorized as possibly/probably/definitely related to NPH surgery.
RESULTS
In 10/22 (45.5%) operated subjects, there were 11 qualifying SAEs over this 3-year period: 1 central nervous system infections, 4 subdural hematomas, 2 seizures resulting in hospitalization, 1 catheter malfunction, 2 perioperative AEs, and 1 death of uncertain cause. Eight SAEs were coded as probably/definitely related. Six occurred >3 months from the time of surgery.
CONCLUSIONS
SAEs following NPH surgery are common. Additional studies are needed to determine the long-term safety of NPH surgery in older adults.
目的
近期的正常压力脑积水（NPH）实践指南描述了手术后严重不良事件（SAE）发生率为11%。
患者与方法
我们对在47个月期间（2014年2月至2017年12月）在我们中心多学科NPH诊所接受检查的162例连续患者进行了回顾性研究。其中，22例最终接受了神经外科脑室分流手术以治疗NPH。对临床记录进行审查，以查找归类为可能/很可能/肯定与NPH手术相关的SAE。
结果
在这22例接受手术的受试者中，在这3年期间有10例（45.5%）出现了11例符合条件的SAE：1例中枢神经系统感染、4例硬膜下血肿、2例导致住院的癫痫发作、1例导管故障、2例围手术期不良事件以及1例死因不明的死亡。8例SAE被编码为很可能/肯定相关。其中6例发生在手术后3个月以上。
结论
NPH手术后的SAE很常见。需要进一步研究以确定NPH手术在老年人中的长期安全性。
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