ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2018
Effect of introduction of a standardised peri-operative protocol on CSF shunt infection rate: a single-centre cohort study of 809 procedures.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the power of standardization in pediatric neurosurgery.Neurosurgical review · 2023Pooled it
- Implementation of an adapted perioperative ventriculoperitoneal shunting protocol in a tertiary center located in a low-to-middle-income country.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Reducing ventriculoperitoneal shunt infection with intraoperative glove removal.Infection control and hospital epidemiology · 2023Article
- Current Perspectives on the Diagnosis and Management of Healthcare-Associated Ventriculitis and Meningitis.Infection and drug resistance · 2022Review
- Global trends in the evaluation and management of cerebrospinal fluid shunt infection: a cooperative ISPN survey.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
- Ventriculoperitoneal Shunt Complication in Pediatric Hydrocephalus: Risk Factor Analysis from a Single Institution in Nepal.Asian journal of neurosurgeryArticle
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4 authors.
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Abstract
purposeShunt infection is a major problem in paediatric neurosurgery. Our institution introduced a mandatory shunt protocol with the aim of reducing infection rate.
methodsA retrospective cohort study including consecutive patients undergoing permanent shunt operations (primary insertion and revision) across two study periods: 3 years immediately prior (2009-2012) and 3 years immediately after (2012-2015) protocol introduction. Absolute and relative risk reductions (ARR/RRR) and Chi-square statistical analysis was used alongside logistic regression, where any single factor with p ≤ 0.20 included in the multivariate model, producing an odds ratio (OR).
resultsEight hundred nine operations in 504 children were identified (442 pre-protocol, 367 post). Overall infection rate decreased from 5.43% (24/442) pre-protocol to 3.27% (12/367) post-protocol (ARR = 2.16%, RRR = 39.8%, NNT = 46.3, p = 0.138), which did not reach statistical significance. For primary shunt insertions, infection rate reduced from 3.63 to 2.55% (ARR = 1.08%, RRR = 29.8%, NNT = 92.6, p = 0.565), whilst for revisions, it reduced from 6.83 to 3.81% (ARR = 3.02%, RRR 44.2%, NNT = 33.1, p = 0.156). Multivariate logistic regression showed that surgeon experience was a statistically significant predictor of infection, whilst responsible pathogens and latency were similar across the pre- and post-protocol groups.
conclusionThe protocol reduced overall infection rate in primary and revision shunt operations and we recommend paediatric units consider introducing a similar protocol for these procedures.
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