Artikel
Increased body weight in hydrocephalus patients: risk factor in shunting procedures?
Suche in Medline nach
Autoren
Veröffentlicht: | 8. Juni 2016 |
---|
Gliederung
Text
Objective: Despite all surgical care hydrocephalus shunting procedures are associated with several complications and risks. This study was designed to evaluate possible complications of hydrocephalus shunting procedures depending on patients’ weight.
Method: Patient charts were reviewed retrospectively for type of hydrocephalus, pre-treatment, type of shunting and of the utilized valves and catheters, body-mass index (BMI), co-morbidities, neurological performance pre- and postoperatively and any shunt-associated complications during the follow-up.
Results: 302 consecutive patients (male 158, female 144; mean age 56.7 years) with ventriculoperitoneal or ventriculoatrial shunting procedures and known BMI were included in the study. The mean BMI was 26.6kg/m2 (range 16.6 to 62.2kg/m2) with 38.1% overweight (BMI 25-30kg/m2) and 24.2% obese (BMI >30kg/m2) patients. During the follow-up 34.4% of all patients required revision due to mechanical dysfunction (13.6%), infection (10.9%) and malpositioning of the catheters (9.6%). The revision rates were 34.8% in normal weight patients, 29.6% in overweight patients and 41.1% in obese patients. Obese patients had significantly higher malpositioning rates of ventricular catheters (10.9% vs. 2.7%, p=0.033) and a trend to higher malpositioning rates of peritoneal catheters (10.9% vs. 3.6%, p=0.062) compared to normal weight patients. There was no significant difference in the infection rates between normal weight (10.9%), overweight (10.4%) and obese patients (12.3%).
Conclusions: In our patient population, obese patients had a significantly higher risk of surgical revision due to catheter malpositioning.