title: Ventriculoperitoneal (VP) Shunt Survival in Patients Developing Hydrocephalus After Cranial Surgery.
abstract: OBJECTIVE
  Ventriculoperitoneal (VP) shunt insertion remains the most popular method for the treatment of hydrocephalus despite its associated complications. We assessed VP shunt survival in a group of patients who had developed hydrocephalus following cranial surgery.
  
  
  METHODS
  A retrospective charts review was done over a 10-year period at our institution. Kaplan-Meier survival curves and Log-Rank (Cox-Mantel) test were used to analyze various factors affecting VP shunt survival.
  
  
  RESULTS
  Among the 67 cases included, a total of 28 (46.3%) patients had undergone cranial surgery for brain tumors. The overall rate of shunt failure was 14.9% at a mean follow-up of 16 months. Shunt failure in pediatric patients (20%) was slightly higher than that in adult patients (13.5%). The median time to first shunt failure was adversely influenced by a history of brain tumor (p = 0.019), prolonged antibiotic therapy (p = 0.018) and administration of steroids (p = 0.004).
  
  
  CONCLUSIONS
  Shunt survival was worse in patients who developed hydrocephalus following cranial surgery performed for brain tumors and those who received either steroids or prolonged antibiotic therapy. Thus post-cranial surgery hydrocephalus represents a unique subset of hydrocephalus.
authors.affiliation: The Aga Khan University Hospital, Department of Surgery, Section of Neurosurgery, Karachi, Sindh, Pakistan.
authors.forename: Farid
authors.initials: F
authors.lastname: Khan
authors.forename: Abdul
authors.initials: A
authors.lastname: Rehman
authors.forename: Muhammad Shahzad
authors.initials: MS
authors.lastname: Shamim
authors.forename: Muhammad Ehsan
authors.initials: ME
authors.lastname: Bari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000601:surgery*; D002648:Child; D019468:Disease Management; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000401:mortality*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects* / Q000706:statistics & numerical data; D055815:Young Adult