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埃塞俄比亚接受脑积水脑室腹腔分流手术的儿科患者的生存状况及死亡决定因素

Survival status and determinant factors of mortality among pediatric patients who underwent ventriculoperitoneal shunting surgery for hydrocephalus in Ethiopia.

作者信息

Menberu Mathewos Sileshi, Mohammed Abdurehman Seid, Kebede Yared Negussie, Diress Getachew Mekete

机构信息

Department of Public Health, Kidus Petros Specialized Hospital, Addis Ababa, Ethiopia.

Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMC Surg. 2025 Apr 15;25(1):158. doi: 10.1186/s12893-025-02896-8.

Abstract

BACKGROUND

Ventriculoperitoneal (VP) shunting is one of the most common neurosurgical procedures for treating hydrocephalus. This study aimed to assess the Survival status and determinant factors of pediatric patients who underwent ventriculoperitoneal shunting for hydrocephalus.

METHODS

A multicenter institutional-based retrospective cohort study was employed by reviewing medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus from 1/12/2015 to 30/02/2023 and the medical chart records review was employed from 1/03/2023 to 30/03/2023. Data were extracted using a pre-tested, structured questionnaire. The Cox proportional hazard model was used to identify determinants of pediatric patient survival, where the hazard ratio, p-values, and 95% CI for adjusted hazard ratio were used to test significance and interpret the results. A p-value of < 0.05 was considered statistically significant.

RESULTS

Seven hundred sixty-nine medical chart records of pediatric patients who underwent ventriculoperitoneal (VP) shunting surgery for hydrocephalus were selected and reviewed with a response rate of 87.89%. The median survival time of pediatric patients after surgery was 15 months. On the multivariable Cox proportional hazard model, ultrasound image (AHR: 4.257, 95% CI: 2.07-8.74), emergency type of surgery (AHR: 2.180, 95% CI: 1.20-3.95), additional procedures other than shunting (AHR: 2.089, 95% CI: 1.05-4.16), duration of stay (> 7 days) (AHR: 4.014, 95% CI: 1.28-12.57), shunt failure (AHR: 4.163, 95% CI: 2.32-7.47), and clinical follow-up (AHR: 2.606, 95% CI: 1.31-5.17) were found to be determinants factors of survival status the patients.

CONCLUSION

The survival time to death was 15 months, and the mortality rate for shunting surgery for hydrocephalus was 24.58%. In this study, emergency type of surgery, additional procedures other than shunt, duration of stay (> 7 days), shunt failure, and no hospital follow-up were factors associated with the mortality of the patients.

摘要

背景

脑室腹腔(VP)分流术是治疗脑积水最常见的神经外科手术之一。本研究旨在评估接受脑室腹腔分流术治疗脑积水的儿科患者的生存状况及决定因素。

方法

采用多中心基于机构的回顾性队列研究,回顾2015年12月1日至2023年2月28日接受脑室腹腔(VP)分流术治疗脑积水的儿科患者的病历记录,并于2023年3月1日至2023年3月31日进行病历记录审查。使用预先测试的结构化问卷提取数据。采用Cox比例风险模型确定儿科患者生存的决定因素,其中风险比、p值和调整后风险比的95%置信区间用于检验显著性并解释结果。p值<0.05被认为具有统计学意义。

结果

选取769例接受脑室腹腔(VP)分流术治疗脑积水的儿科患者的病历记录进行审查,回复率为87.89%。儿科患者术后的中位生存时间为15个月。在多变量Cox比例风险模型中,超声图像(调整后风险比:4.257,95%置信区间:2.07 - 8.74)、急诊手术类型(调整后风险比:2.180,95%置信区间:1.20 - 3.95)、分流以外的其他手术(调整后风险比:2.089,95%置信区间:1.05 - 4.16)、住院时间(>7天)(调整后风险比:4.014,95%置信区间:1.28 - 12.57)、分流失败(调整后风险比:4.163,95%置信区间:2.32 - 7.47)和临床随访(调整后风险比:2.606,95%置信区间:1.31 - 5.17)被发现是患者生存状况的决定因素。

结论

死亡的生存时间为15个月,脑积水分流手术的死亡率为24.58%。在本研究中,急诊手术类型、分流以外的其他手术、住院时间(>7天)、分流失败和无医院随访是与患者死亡率相关的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4531/11998264/c607523bef64/12893_2025_2896_Fig1_HTML.jpg

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