title: Lower incidence of reoperation with longer shunt survival with adult ventriculoperitoneal shunts placed for hemorrhage-related hydrocephalus.
abstract: OBJECTIVE
  The incidence of reoperation for ventriculoperitoneal shunts (VPS) in adults, although lower than in pediatric patients, is not insignificant. We hypothesize that adult VPS placed for hemorrhage-related hydrocephalus have a lower incidence of reoperation than those placed for other types of hydrocephalus.
  
  
  METHODS
  We retrospectively reviewed all adult (>/= 20 yr) VPS initially placed from February 2001 to August 2006 at the University of Florida. We determined the incidence and time interval to reoperation. Follow-up was conducted by telephone interview and review of medical records.
  
  
  RESULTS
  A total of 286 adult VPS were initially placed: 96 (34%) hemorrhage and 190 (66%) nonhemorrhage. A total of 15 (16%) hemorrhage patients underwent 22 shunt reoperations, compared with 50 (27%) nonhemorrhage patients who underwent 82 shunt reoperations (P = 0.0316). A Poisson regression analysis of the number of reoperations, factoring hemorrhage, age, and sex, demonstrated a significantly lower incidence of reoperation in hemorrhage patients (P = 0.0900). A Cox proportional hazards model analysis of time to first reoperation, factoring hemorrhage, age, and sex, demonstrated a significantly longer shunt survival in hemorrhage patients (P = 0.0404).
  
  
  CONCLUSIONS
  Adult VPS placed for hemorrhage-related hydrocephalus have a significantly lower incidence of reoperation and significantly longer shunt survival. This result may be related to an incidence of transient shunt dependency in patients with hemorrhage-related hydrocephalus. However, the precise mechanism remains unclear.
authors: Department of Neurological Surgery, University of Florida College of Medicine, Gainesville, Florida 32610, USA. brian.hoh@neurosurgery.ufl.edu
authors: Brian L
authors: BL
authors: Hoh
authors: Shih-Shan
authors: SS
authors: Lang
authors: Michael V
authors: MV
authors: Ortiz
authors: Yueh-Yun
authors: YY
authors: Chi
authors: Stephen B
authors: SB
authors: Lewis
authors: David W
authors: DW
authors: Pincus
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects / Q000379:methods*