PREDICTION OF VENTRICULOPERITONEAL SHUNT MALFUNCTION WITH CLINICAL FACTORS IN CHILDREN
Abstract
Background
Shunt malfunction is one of the most important complication in patients with ventriculoperitoneal shunt.
Objectives
We aimed to evaluate whether malfunction of ventriculoperitoneal shunt could be predicted with several clinical factors.
Methods
We retrospectively reviewed clinical date of electronic medical record in single tertiary hospital of pediatric emergency department (PED). Patients who presented with suspicious symptoms of shunt malfunction such as fever, vomiting, headache, altered mental status, seizure and neurologic deficit were included. Shunt malfunction was defined if increase of ventricular size were documented in brain CT. Other demographic, clinical and shunt-related data are also collected. Univariate logistic regression analysis was used to evaluate association of factors with shunt malfunction.
Results
Among 68 patients who visited PED with suspicious symptoms, 31 (45.6%) were diagnosed as shunt malfunction. Median age was 4 [interquartile range 2 – 11]. History of vomiting [OR 2.60, p = 0.056] and fever [OR 0.25, p = 0.052] were the best predictive clinical factors but not statistically significant. History of headache [OR 1.23, p = 0.82], altered mental status [OR 1.95, p = 0.20], neurologic deficit [OR 1.67, p = 0.52], previous shunt malfunction [0.69, p = 0.626] and postoperative day more than 1 year [OR 1.72, p = 0.28] also not significantly associated with shunt malfunction.
Conclusion
We found out that it was difficult to predict shunt malfunction with clinical factors in PED. We recommend to take the brain CT when shunt malfunction is suspected.