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Ventriculoperitoneal shunting obstruction: a multicentre clinical audit for cerebrospinal fluid parameters and its prediction role

  • Clinical Trial article
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Abstract

Background

Shunt obstruction is a type of ventriculoperitoneal shunt (VPS) failure. Whether changes in cerebrospinal fluid (CSF) parameters can influence shunt outcomes or not is debatable.

Methods

In this study, we retrospectively included adult hydrocephalus patients who received VPS from 6 general hospitals in different provinces of China from November 2013 to September 2021. The inclusion criteria: Patients with hydrocephalus of all etiologies underwent shunt surgery from 6 general hospitals in different provinces of China were included in the study. The exclusion criteria: 1.Patients under the age of 18; 2.Patients who had previous shunt surgery; 3. Shunt failure from other factors; 4.Patients died from other causes; 5. Patients with incomplete data. The CSF of shunt patients had been analyzed at the time of shunt insertion. The CSF samples were collected and analyzed when the shunt was implanted. The relationship between CSF parameters and the incidence rate of shunt obstruction in one year was analyzed.

Results

A total of 717 eligible patients from 6 hospitals were included, of whom 59(8.23%) experienced obstruction. Multivariate logistic regression analysis identified that protein level(odds ratio [OR] 1.161, 95% CI 1.005 ~ 1.341, p = 0.043), decreased glucose level(< 2.5 mmol/L)(odds ratio 3.784, 95% confidence interval 1.872 ~ 7.652, p = 0.001) and protein level increase(> 0.45 g/L) (odds ratio 3.653, 95% confidence interval 1.931 ~ 6.910, p = 0.001)were independent risk factors of shunt obstruction.

Conclusion

This study suggested that increased protein level (> 0.45 g/L) and decreased glucose level (< 2.5 mmol/L) in CSF indicated an increased risk of shunt obstruction in a patient with hydrocephalus. Thus, shunt surgery should be more carefully considered when the CSF glucose and protein were abnormal.

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Data availability

All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Funding

Project 82101424 supported by NSFC.

Author information

Author notes

  1. Hao Xu, Jiawei He, Shouren Chen, Caiquan Huang, Kai Zhao, Shaolin Zhang and Anshuo Wang contribute eqully to this work.

Authors and Affiliations

  1. Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China

    Hao Xu & Anshuo Wang

  2. Department of Neurosurgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Xiamen University, Zhangzhou, 363300, Fujian, China

    Shouren Chen & Xinfeng Liu

  3. Department of neurosurgery, The first Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361000, Fujian, China

    Jiawei He

  4. Department of Neurosurgery, Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, Hubei, China

    Caiquan Huang

  5. Department of Neurosurgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China

    Kai Zhao

  6. Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241001, Anhui, China

    Shaolin Zhang

  7. Department of Neurosurgery, Center for Pituitary Tumor Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China

    Shaolin Zhang

Authors
  1. Hao Xu
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Contributions

Hao Xu contributed to the conception of the study; Hao Xu, Jiawei He, Shouren Chen, Caiquan Huang, Shaolin Zhang and Kai Zhao collected the data, Hao Xu and Anshuo Wang contributed analysis and manuscript preparation; Hao Xu wrote the manuscrip; Xinfeng Liu review the manuscript.

Corresponding author

Correspondence to Xinfeng Liu.

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Ethics statement

The authors abide by academic ethics and morality. All respondents stated that the data in the questionnaires were available for research. We confirm that all methods were carried out in accordance with relevant guidelines and regulations. We confirm that all experimental protocols were approved by a Ethical Review Board named institutional and licensing committee of USTC. We confirm that informed consent was obtained from all subjects or, if subjects are under 18, from a parent and/or legal guardian. The ethical approval number is 2021RE146.

Conflict of interest

We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

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Xu, H., He, J., Chen, S. et al. Ventriculoperitoneal shunting obstruction: a multicentre clinical audit for cerebrospinal fluid parameters and its prediction role. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07551-3

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