ArticleFrontiers in neurology2025
Analysis of risk factors for delayed intracranial hemorrhage following ventriculoperitoneal shunt surgery and construction of a nomogram model.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: The objective of this study is to identify the independent risk factors associated with delayed intracranial hemorrhage (DICH) subsequent to ventriculoperitoneal shunt (VPS) surgery in patients diagnosed with hydrocephalus and to construct a nomogram model for this condition. Methods: We conducted a retrospective analysis of clinical data from 266 patients who underwent VPS procedures at Ningbo University Affiliated Lihuili Hospital between January 2015 and December 2024. The patients were stratified into two groups: those with postoperative DICH (DICH group) and those without (non-DICH group). Initially, univariate analysis was used to evaluate differences in clinical data between the two groups. Subsequently, multivariate logistic regression analysis was employed to identify independent risk factors for DICH ( Results: The incidence of DICH was observed to be 17.3% (46/266). Statistical analysis revealed that the DICH group had significantly higher age, a greater prevalence of previous craniotomy, and an elevated postoperative-to-preoperative neutrophil-to-lymphocyte ratio ratio (NLRR) compared to the non-DICH group ( Conclusion: Advanced age, a history of craniotomy, and elevated NLRR are independent risk factors for DICH following VPS in hydrocephalus patients. The constructed nomogram model for predicting DICH occurrence after VPS surgery in hydrocephalus patients exhibits favorable predictive performance. Postoperatively, enhanced vigilance for DICH is recommend when any of these risk factors are present postoperatively. Increasing the frequency of postoperative head CT scans may improve detection sensitivity for asymptomatic patients with minor bleeding, thereby facilitating early intervention.
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