Endoscopic Third Ventriculostomy in the Treatment of Childhood Hydrocephalus

被引:289
作者
Kulkarni, Abhaya V. [1 ]
Drake, James M. [1 ]
Mallucci, Conor L. [2 ]
Sgouros, Spyros [3 ]
Roth, Jonathan [4 ]
Constantini, Shlomi [4 ]
机构
[1] Hosp Sick Children, Toronto, ON M5G 1X8, Canada
[2] Royal Liverpool Childrens Hosp, Liverpool L7 7DG, Merseyside, England
[3] Birmingham Childrens Hosp, Birmingham, W Midlands, England
[4] Tel Aviv Med Ctr & Sch Med, Dana Childrens Hosp, IL-64239 Tel Aviv, Israel
关键词
FLUID SHUNT INFECTION; PREDICTIVE MODELS; CHILDREN; VALIDATION; MANAGEMENT; INFANTS; SUCCESS; RISK; 3RD-VENTRICULOSTOMY; COMPLICATIONS;
D O I
10.1016/j.jpeds.2009.02.048
中图分类号
R72 [儿科学];
学科分类号
100202 [儿科学];
摘要
Objective To develop a model to predict the probability of endoscopic third ventriculostomy (ETV) success in the treatment for hydrocephalus on the basis of a child's individual characteristics. Study design We analyzed 618 ETVs performed consecutively on children at 12 international institutions to identify predictors of ETV success at 6 months. A multivariable logistic regression model was developed on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Results In the training set, 305/455 ETVs (67.0%) were successful. The regression model (containing patient age, cause of hydrocephalus, and previous cerebrospinal fluid shunt) demonstrated good fit (Hosmer-Lemeshow, P = .78) and discrimination (C statistic = 0.70). In the validation set, 105/163 ETVs (64.4%) were successful and the model maintained good fit (Hosmer-Lemeshow, P = .45), discrimination (C statistic = 0.68), and calibration (calibration slope = 0.88). A simplified ETV Success Score was devised that closely approximates the predicted probability of ETV success. Conclusions Children most likely to succeed with ETV can now be accurately identified and spared the long-term complications of CSF shunting. (J Pediatr 2009; 155:254-9).
引用
收藏
页码:254 / 259
页数:6
相关论文
共 41 条
[1]
Is the success rate of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in young children [J].
Beems, T ;
Grotenhuis, JA .
CHILDS NERVOUS SYSTEM, 2002, 18 (11) :605-608
[2]
3-month and 12-month mortality after first liver transplant in adults in Europe: predictive models for outcome [J].
Burroughs, AK ;
Sabin, CA ;
Rolles, K ;
Delvart, V ;
Karam, V ;
Buckels, J ;
O'Grady, JG ;
Castaing, D ;
Klempnauer, J ;
Jamieson, N ;
Neuhaus, P ;
Lerut, J ;
de Goyet, JD ;
Pollard, S ;
Salizzoni, M ;
Rogiers, X ;
Muhlbacher, F ;
Valdecasas, JCG ;
Broelsch, C ;
Jaeck, D ;
Berenguer, J ;
Gonzalez, EM ;
Adam, R .
LANCET, 2006, 367 (9506) :225-232
[3]
Dandy WE., 1922, Johns Hopkins Hosp Bull, V33, P189
[4]
Reduction in neural-tube defects after folic acid fortification in Canada [J].
De Wals, Philippe ;
Tairou, Fassiatou ;
Van Allen, Margot I. ;
Uh, Soo-Hong ;
Lowry, R. Brian ;
Sibbald, Barbara ;
Evans, Jane A. ;
Van den Hof, Michiel C. ;
Zimmer, Pamela ;
Crowley, Marian ;
Fernandez, Bridget ;
Lee, Nora S. ;
Niyonsenga, Theophile .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (02) :135-142
[5]
Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review [J].
Di Rocco, C. ;
Massimi, L. ;
Tamburrini, G. .
CHILDS NERVOUS SYSTEM, 2006, 22 (12) :1573-1589
[6]
Endoscopic third ventriculostomy in pediatric patients: The Canadian experience [J].
Drake, James M. .
NEUROSURGERY, 2007, 60 (05) :881-885
[7]
Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus [J].
Drake, JM ;
Kestle, JRW ;
Milner, R ;
Cinalli, G ;
Boop, F ;
Piatt, J ;
Haines, S ;
Schiff, SJ ;
Cochrane, DD ;
Steinbok, P ;
MacNeil, N ;
Haines, S ;
Sainte-Rose, C ;
Poskitt, K ;
Goumnerova, L ;
Albright, AL ;
Cinalli, G ;
Pierre-Kahn, A ;
Renier, D ;
Zerah, M ;
Rutka, J ;
Humphreys, R ;
Hoffman, H ;
Lamberti-Pasculi, M ;
Teo, C ;
Cherny, B ;
Aureli, S ;
Vandertop, P ;
Broomstra, S ;
Chadduck, W ;
Donahue, D ;
Hall, W ;
Parent, A ;
Turmel, A ;
Myles, T ;
Hamilton, M ;
Oakes, J ;
Mapstone, T .
NEUROSURGERY, 1998, 43 (02) :294-303
[8]
CSF shunts 50 years on - past, present and future [J].
Drake, JM ;
Kestle, JRW ;
Tuli, S .
CHILDS NERVOUS SYSTEM, 2000, 16 (10-11) :800-804
[9]
Success of endoscopic third ventriculostomy in children less than 2 years of age [J].
Etus, V ;
Ceylan, S .
NEUROSURGICAL REVIEW, 2005, 28 (04) :284-288
[10]
Endoscopic third ventriculostomy in infants [J].
Fritsch, MJ ;
Kienke, S ;
Ankermann, T ;
Padoin, M ;
Mehdorn, HM .
JOURNAL OF NEUROSURGERY, 2005, 103 (01) :50-53