The Impact of Hydrocephalus Shunt Devices on Quality of Life.
Journal
The Journal of craniofacial surgery
ISSN: 1536-3732
Titre abrégé: J Craniofac Surg
Pays: United States
ID NLM: 9010410
Informations de publication
Date de publication:
Historique:
entrez:
28
7
2021
pubmed:
29
7
2021
medline:
31
7
2021
Statut:
ppublish
Résumé
Despite advances in hydrocephalus shunt technology and improvement in hydrocephalus management, many patients have chronic disability and require multiple surgeries throughout their lifetime. There is limited data from patients' perspective regarding the impact of shunt devices on quality-of-life. A cross-sectional survey was developed to evaluate the impact of shunt devices on patient quality-of-life. The survey was distributed via social media platforms of the Hydrocephalus Association, and patients self-selected to anonymously complete the online questionnaire. A literature review was performed to contextualize the findings from the survey. A total of 562 survey responses were obtained from a network encompassing 35,000 members. The mean age was 30 years old (0.5-87), and 65% identified as female. Eighty one percent underwent at least 1 shunt revision surgery, with a reported average of 10 shunt revision surgeries per patient (1-200 surgeries). Occlusion, shunt migration and infection were the leading causes for revision at 60%, 47%, and 35%, respectively. In addition, 72% of patients reported pain and discomfort from the device, and 68% expressed avoidance of certain activities due to "fear of bumping shunt." Despite numerous articles discussing shunt technology, a review of the literature indicated a paucity of studies specifically evaluating the burden of shunt devices from a patient/caregiver perspective. The findings from this study suggest long-term physical and psychosocial burden associated with shunt devices. Importantly, this study highlights the need for concerted efforts to develop validated tools to study patient reported outcomes as it relates to neurocranial implanted devices.
Sections du résumé
BACKGROUND
BACKGROUND
Despite advances in hydrocephalus shunt technology and improvement in hydrocephalus management, many patients have chronic disability and require multiple surgeries throughout their lifetime. There is limited data from patients' perspective regarding the impact of shunt devices on quality-of-life.
METHODS
METHODS
A cross-sectional survey was developed to evaluate the impact of shunt devices on patient quality-of-life. The survey was distributed via social media platforms of the Hydrocephalus Association, and patients self-selected to anonymously complete the online questionnaire. A literature review was performed to contextualize the findings from the survey.
RESULTS
RESULTS
A total of 562 survey responses were obtained from a network encompassing 35,000 members. The mean age was 30 years old (0.5-87), and 65% identified as female. Eighty one percent underwent at least 1 shunt revision surgery, with a reported average of 10 shunt revision surgeries per patient (1-200 surgeries). Occlusion, shunt migration and infection were the leading causes for revision at 60%, 47%, and 35%, respectively. In addition, 72% of patients reported pain and discomfort from the device, and 68% expressed avoidance of certain activities due to "fear of bumping shunt." Despite numerous articles discussing shunt technology, a review of the literature indicated a paucity of studies specifically evaluating the burden of shunt devices from a patient/caregiver perspective.
CONCLUSIONS
CONCLUSIONS
The findings from this study suggest long-term physical and psychosocial burden associated with shunt devices. Importantly, this study highlights the need for concerted efforts to develop validated tools to study patient reported outcomes as it relates to neurocranial implanted devices.
Identifiants
pubmed: 34319679
doi: 10.1097/SCS.0000000000007579
pii: 00001665-202108000-00024
doi:
Substances chimiques
Dental Implants
0
Types de publication
Journal Article
Review
Langues
eng
Pagination
1746-1750Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.
Déclaration de conflit d'intérêts
Dr Gordon is a consultant for Stryker, OsteoMed, DePuy-Synthes, and Longeviti Neuro Solutions. Dr Huang and Dr Gordon are stockholders in Longeviti Neuro Solutions. All other authors report no conflicts of interest.
Références
Isaacs AM, Riva-Cambrin J, Yavin D, et al. Age-specific global epidemiology of hydrocephalus: systematic review, metanalysis and global birth surveillance. PLoS One 2018; 13:e0204926.
Isaacs AM, Bezchlibnyk YB, Yong H, et al. Endoscopic third ventriculostomy for treatment of adult hydrocephalus: long-term follow-up of 163 patients. Neurosurg Focus 2016; 41:E3.
Reddy GK, Bollam P, Caldito G. Long-term outcomes of ventriculoperitoneal shunt surgery in patients with hydrocephalus. World Neurosurg 2014; 81:404–410.
Stein SC, Guo W. Have we made progress in preventing shunt failure? A critical analysis. J Neurosurg Pediatr 2008; 1:40–47.
Gordon CR, Wolff A, Santiago GF, et al. First-in-human experience with integration of a hydrocephalus shunt device within a customized cranial implant. Oper Neurosurg (Hagerstown) 2019; 17:608–615.
Kaestner S, Poetschke M, Kehler U, et al. Revision surgery following CSF shunt insertion: how often could it be avoided? Acta Neurochir (Wien) 2020; 162:9–14.
Stone JJ, Walker CT, Jacobson M, et al. Revision rate of pediatric ventriculoperitoneal shunts after 15 years. J Neurosurg Pediatr 2013; 11:15–19.
Anderson IA, Saukila LF, Robins JMW, et al. Factors associated with 30-day ventriculoperitoneal shunt failure in pediatric and adult patients. J Neurosurg 2018; 130:145–153.
Paulsen AH, Lundar T, Lindegaard KF. Twenty-year outcome in young adults with childhood hydrocephalus: assessment of surgical outcome, work participation, and health-related quality of life. J Neurosurg Pediatr 2010; 6:527–535.
Beez T, Bellstädt L, Steiger HJ, et al. Headache and shunt-related impact on activities of daily life in patients growing up with a ventriculoperitoneal shunt. J Neurol Surg A Cent Eur Neurosurg 2018; 79:196–199.
Junkkari A, Sintonen H, Nerg O, et al. Health-related quality of life in patients with idiopathic normal pressure hydrocephalus. Eur J Neurol 2015; 22:1391–1399.
Prakash P, Dhandapani M, Ghai S, et al. Quality of life among children who had undergone ventriculoperitoneal shunt surgery. J Pediatr Neurosci 2018; 13:189–194.
Pan P. Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus. J Pediatr Neurosci 2018; 13:176–181.
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6:e1000097.
Kulkarni AV, Rabin D, Drake JM. An instrument to measure the health status in children with hydrocephalus: the Hydrocephalus Outcome Questionnaire. J Neurosurg 2004; 101: (2 Suppl): 134–140.
Kulkarni AV, Donnelly R, Shams I. Comparison of Hydrocephalus Outcome Questionnaire scores to neuropsychological test performance in school-aged children. J Neurosurg Pediatr 2011; 8:396–401.
Platenkamp M, Hanlo PW, Fischer K, et al. Outcome in pediatric hydrocephalus: a comparison between previously used outcome measures and the hydrocephalus outcome questionnaire. J Neurosurg 2007; 107: (1 Suppl): 26–31.
Kutscher A, Nestler U, Bernhard MK, et al. Adult long-term health-related quality of life of congenital hydrocephalus patients. J Neurosurg Pediatr 2015; 16:621–625.
Paulsen AH, Lundar T, Lindegaard KF. Pediatric hydrocephalus: 40-year outcomes in 128 hydrocephalic patients treated with shunts during childhood. Assessment of surgical outcome, work participation, and health-related quality of life. J Neurosurg Pediatr 2015; 16:633–641.
Bondurant CP, Jimenez DF. Epidemiology of cerebrospinal fluid shunting. Pediatr Neurosurg 1995; 23:254–258. discussion 259.
Patwardhan RV, Nanda A. Implanted ventricular shunts in the United States: the billion- dollar-a-year cost of hydrocephalus treatment. Neurosurgery 2005; 56:139–144. discussion 144-135.
Khan F, Rehman A, Shamim MS, et al. Factors affecting ventriculoperitoneal shunt survival in adult patients. Surg Neurol Int 2015; 6:25.
Kofoed Månsson P, Johansson S, Ziebell M, et al. Forty years of shunt surgery at Rigshospitalet, Denmark: a retrospective study comparing past and present rates and causes of revision and infection. BMJ Open 2017; 7:e013389.
Choux M, Genitori L, Lang D, et al. Shunt implantation: reducing the incidence of shunt infection. J Neurosurg 1992; 77:875–880.
Ronan A, Hogg GG, Klug GL. Cerebrospinal fluid shunt infections in children. Pediatr Infect Dis J 1995; 14:782–786.
Bot GM, Ismail NJ, Usman B, et al. Subpericranial shunt valve placement: a technique in patients with friable skin. Childs Nerv Syst 2014; 30:1431–1433.
Nguyen TA, Cohen PR. Scalp necrosis overlying a ventriculoperitoneal shunt: a case report and literature review. Dermatol Online J 2015; 21: 13030/qt2rs544f9.
Riva-Cambrin J, Kestle JR, Holubkov R, et al. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study. J Neurosurg Pediatr 2016; 17:382–390.
Preuss M, Kutscher A, Wachowiak R, et al. Adult long-term outcome of patients after congenital hydrocephalus shunt therapy. Childs Nerv Syst 2015; 31:49–56.
Iglesias S, Ros B, Martín Á, et al. Functional outcome in pediatric hydrocephalus: results of applying the Spanish version of the Hydrocephalus Outcome Questionnaire. J Neurosurg Pediatr 2018; 21:224–235.
Mitchell KS, Gordon C. Discussion of surgical and patient-reported outcomes in patients with PEEK versus titanium cranioplasty reconstruction. J Craniofac Surg 2021; 32:198–200.
Pusic AL, Klassen AF, Scott AM, et al. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 2009; 124:345–353.
Prahalad P, Tanenbaum M, Hood K, et al. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes. Diabet Med 2018; 35:419–429.
Gordon CR, Huang J, Brem H. Neuroplastic surgery. J Craniofac Surg 2018; 29:4–5.
Mallucci CL, Jenkinson MD, Conroy EJ, et al. Antibiotic or silver versus standard ventriculoperitoneal shunts (BASICS): a multicentre, single-blinded, randomised trial and economic evaluation. Lancet 2019; 394:1530–1539.