title: Death in shunted hydrocephalic children: a follow-up study.
abstract: BACKGROUND
  The authors previously conducted a retrospective study regarding deaths from CSF shunt failure to identify circumstances surrounding shunt malfunction-related deaths in children in the modern era.
  
  
  METHODS
  Using the same methodology, we conducted a follow-up study to determine whether recent policy and procedural changes instituted since the time of the first study had effected a change in the mortality rate of our shunted patient population.
  
  
  RESULTS
  Thirty-nine original patient records (of patients seen at Children's Hospital who died with the diagnosis of hydrocephalus between 1998 and 2004) were identified and reviewed for inclusion into the study. Only four (10.3%) were found to have died directly as a result of shunt malfunction.
  
  
  CONCLUSIONS
  Our rate of shunt malfunction death has decreased over time. It is reasonable to attribute part of this decline to continued improvements in diagnostic and therapeutic techniques and to the use of surveillance scans to identify asymptomatic patients with shunt failure. However, we believe the majority of this decline is due to two additional factors: (1) increased nursing staff and (2) effective patient/family education.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital, 1600 7th Avenue South ACC 400, Birmingham, AL 35233, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Acakpo-Satchivi
authors.forename: Chevis N
authors.initials: CN
authors.lastname: Shannon
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: John C
authors.initials: JC
authors.lastname: Wellons
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
authors.forename: Bermans J
authors.initials: BJ
authors.lastname: Iskandar
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D004868:Equipment Failure; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality* / Q000601:surgery*; D009729:Nursing; D010353:Patient Education as Topic; D000078329:Workforce