Systematic follow-ups were not associated with reduced acute ventriculoperitoneal shunt dysfunction in infancy

Aim: Hydrocephalus surgery with a ventriculoperitoneal shunt is a life-saving treatment, but it has been associated with a high risk of dysfunction and complications. We investigated whether infants who received a ventriculoperitoneal shunt below 12 months of age had a reduced risk of acute shunt dysfunction if they were included in a structured follow-up programme.

Methods: A population-based, retrospective chart review was performed at Uppsala University Children's Hospital, Sweden. Patients were identified by International Classification of Diseases, Tenth Revision codes and surgical codes from 1 January 2005 to 31 December 2019. Those who received the structured follow-up programme from April 2012 were compared with historical controls.

Results: We identified 95 patients (66% male): 47 in the follow-up group and 48 controls. Their mean age was 2.6 (range 0-12) months. There was a high 44% acute shunt dysfunction rate during the first year after primary surgery: 38% in the follow-up group and 50% in the control group (p = 0.25). The difference was not significant.

Conclusion: The structured follow-up programme was not associated with a significant reduction in acute shunt dysfunction. Predictive models could help to identify patients at risk for shunt dysfunction and complications and improve surveillance and follow-up programmes.