Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children

KANIK, ALİ; ANIL, Murat; Helvacı, Mehmet; ELİAÇIK, Kayı; Kose, Engin; SIRIN, Seda

Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children

Ali KANIK, (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Seda SIRIN, (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Engin KÖSE, (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Kayı ELİAÇIK, (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Murat ANIL, (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Mehmet HELVACI (Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Turkish Neurosurgery

5 0

Yıl: 2015 Cilt: 25 Sayı: 1 Sayfa Aralığı: 58 - 62 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children

Öz:

AMAÇ: Ventriküloperitoneal şant enfeksiyonu geçiren çocukların klinik ve ekonomik sonuçlarının değerlendirilmesi amaçlandıYÖNTEM ve GEREÇLER: Çalışmaya 1 Ocak 2007 ile 31 Aralık 2011 tarihleri arasında ilk kez ventriküloperitoneal şant enfeksiyonu tanısı alanolgular alındı. Hastaların demografik ve klinik özellikleri ile enfeksiyonun maliyeti değerlendirildi. Her bir hasta için maliyet (toplam maliyet /izlem süresi) ve yatış süresi (hastanede yatış süresi / izlem süresi) katsayıları hesaplandı.BULGULAR: Toplam 51 olgudaki (ortalama yaş: 2,58±1,75 ay; ortanca yaş: 3 ay: dağılım aralığı: 1-88 ay; 28 kız / 21 erkek) 132 şant enfeksiyonu(ortalama izlem süresi: 734± 367 gün) değerlendirilmeye alındı. Olguların 23ünde (%45) ilk enfeksiyon şantın takılmasından sonraki ilk 2 aydaortaya çıktı. Toplam yedi hasta izlemde kaybedildi. Olguların tanı yaşları ile yatış süresi katsayıları arasında negatif yönde anlamlı bir korelasyonolduğu görüldü (p=0,005; r = - 0,381). Bir hasta için yatış başına düşen ortalama maliyet 6397±4338 TL olarak hesaplandı. Bu hastaların maliyetkatsayısı ile tanı yaşı arasında negatif yönde anlamlı bir korelasyon saptandı (p=0,04; r = -0,292). SONUÇ: Ventriküloperitoneal şant enfeksiyonları ciddi tıbbi ve ekonomik sonuçlara neden olmaktadır. Hastaların tanı yaşı küçüldükçehastanede yatış süreleri ve tedavi maliyetleri artmaktadır.

Anahtar Kelime:

Konular: Cerrahi

Çocuklarda Ventriküloperitoneal Şant Enfeksiyonlarının Klinik ve Ekonomik Sonuçları

Öz:

AIM: This study evaluated the clinical and economic outcomes of ventriculoperitoneal shunt infections.MATERIAL and METHODS: Patients diagnosed with ventriculoperitoneal shunt infections for the first time between 1 January 2007 and 31December 2011 were included in this study. Demographic, clinical, and economic data were analyzed retrospectively. A cost coefficient (totalcost/follow-up period) and hospitalization coefficient (duration of hospitalization/follow-up period) were calculated for each patient.RESULTS: In total, 132 shunt infections (mean follow-up, 734 ± 367 days) were evaluated in 51 patients (mean age, 16.6 ± 9.22 months; medianage, 3 months; range, 1 88 months; 28 females, 21 males). In 23 patients (45%), shunt infections were seen in the first 2 months following shuntplacement. Seven patients died during the follow-up. There was a negative correlation between the age at diagnosis and the hospitalizationduration (p = 0.005, r = -0.381). The average cost of hospitalization per patient was 6397 ± 4338 TL. There was a negative correlation betweenthe cost index and the age at diagnosis (p = 0.04, r = -0.292). CONCLUSION: Ventriculoperitoneal shunt infections have significant medical and economic impacts. Younger the diagnosis of patients, thehospitalization duration and treatment cost were higher.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Aryan HE, Meltzer HS, Park MS, Bennett RL, Jandial R, Lev ML: Initial experience with antibiotic-impregnated silicon catheter for shunting of cerebrospinal fluid in children. Chil Nerv Syst 21: 5661, 2005
2. Bayston R, Bhundia C, Ashraf W: Hydromer-coated cathete to prevent shunt infection? J Neurosurg 102: 207212, 2005
3. Borgbjerg BM, Gjerris F, Albeck MJ, Borgesen SE: Risk infection after cerebrospinal fluid shunt: An analysis of 88 first-time shunts. Acta Neurochir (Wien) 136: 17, 1995
4. Braga MH, Carvalho GT, Brandao RA, Lima FB, Costa BS: Ear shunt complications in 46 children with hydrocephalus. A Neuropsiquiatr 67: 273237, 2009
5. Celik U, Alhan E: Cerebrospinal fluid shunt infections an treatment. Çocuk Enf Derg 3: 1924, 2009
6. Choux M, Genitori L, Lang D, Lena G: Shunt implantatio Reducing the incidence of shunt infection. J Neurosurg 7 875880, 1992
7. Cochrane DD, Kestle JR: The influence of surgical operativ experience on the duration of first ventriculoperitoneal shu function and infection. Pediatr Neurosurg 38: 295301, 200
8. Eymann R, Chehab S, Strowitzki M, Steudel WI, Kiefer M: Clin cal and economic consequences of antibiotic-impregnate cerebrospinal fluid shunt catheters. J Neurosurg Pedia 1: 444450, 2008
9. Eymann R, Steudel WI, Kiefer M: Infection rate with applicatio of an antibiotic-impregnated catheter for shunt implantatio in children - a retrospective analysis. Klin Padiatr 221: 697 2009
10. Fobe JL, Rizzo AM, Silva IM, Da Silva SP, Teixeira CE, De Souz AM, Fernandes A: IQ in hydrocephalus and myelomeningocel Implications of medical treatment. Arq Neuropsiquiatr 57: 4450, 1999
11. George R, Leibrock L, Epstein M: Long-term analysis of cerebrospinal fluid shunt infections. A 25-year experience. J Neurosurg 51: 804811, 1979
12. Greenbeerg MS: Handbook of Neurosurgery. New York: Thieme Publications, 2010
13. Guzelbag E, Ersahin Y, Mutluer S: Cerebrospinal fluid shunt complications. Turk J Pediatr 39: 363371, 1997
14. Kan P, Kestle J: Lack of efficacy of antibiotic-impregnated shunt systems in preventing shunt infections in children Childs Nerv Syst 23: 773777, 2007
15. Kaufman BA: Infections of cerebrospinal fluid shunts. In: Scheld WM, Whitley RJ, Durack DT (eds), Infections of the Central Nervous System. 2nd ed. Philadelphia: Lippincott Raven, 1997:555577
16. Khan I, Burhan M, Nadeem M: A reappraisal of contributing factors leading to shunt infection. J Ayub Med Coll Abbottabad 21: 6668, 2009
17. Kontny U, Hofling B, Gutjahr P, Voth D, Schwarz M, Schmitt HJ: CSF shunt infections in children. Infection 21: 8992, 1993
18. Kulkarni AV, Drake JM, Lamberti-Pasculli M: Cerebrospinal fluid shunt infection: A prospective study of risk factors. J Neurosurg 94: 195201, 2001
19. Liptak GS, McDonald JV: Ventriculoperitoneal shunts in children: Factors affecting shunt survival. Pediatr Neurosci 12: 289293, 1985
20. Odio C, McCracken GH Jr, Nelson JD: CSF shunt infections in pediatrics: A seven-year experience. Am J Dis Child 138: 11031108, 1984
21. Ratilal B, Costa J, Sampaio C: Antibiotic prophylaxis for surgical introduction of intracranial ventricular shunts. Cochrane Database Syst Rev 19: CD005365, 2006
22. Roos KL, van de Beek D: Bacterial meningitis. Handb Clin Neurol 96: 5163, 2010
23. Telhan L, Cavusoglu F, Musluman M, Turkmenoglu O, Cetinkaya F: Etiologic and prognostic assessment of children with ventriculoperitoneal shunt infections. Çocuk Enf Derg 4: 100103, 2010
24. The Ministry of Health of Turkey: Health Application Notification, Supplementary 89
25. Vinchon M, Dhellemmes P: Cerebrospinal fluid shunt infection: Risk factors and long-term follow-up. Childs Nerv Syst 22: 692697, 2006
26. Walters BC, Goumnerova L, Hoffman HJ, Hendrick EB, Humphreys RP, Levinton C: A randomized controlled trial of perioperative rifampin/trimethoprim in cerebrospinal fluid shunt surgery. Childs Nerv Syst 8: 253257, 1992
27. Wang KW, Chang NW, Shih TY, Huang CR, Tsai NW, Chang CS, et al: Infection of cerebropinal fluid shunts: Causative pathogens, clinical features, and outcomes. Jpn J Infect Dis 57: 4448, 2004

APA	KANIK A, SIRIN S, Kose E, ELİAÇIK K, ANIL M, Helvacı M (2015). Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. , 58 - 62.
Chicago	KANIK ALİ,SIRIN Seda,Kose Engin,ELİAÇIK Kayı,ANIL Murat,Helvacı Mehmet Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. (2015): 58 - 62.
MLA	KANIK ALİ,SIRIN Seda,Kose Engin,ELİAÇIK Kayı,ANIL Murat,Helvacı Mehmet Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. , 2015, ss.58 - 62.
AMA	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. . 2015; 58 - 62.
Vancouver	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. . 2015; 58 - 62.
IEEE	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M "Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children." , ss.58 - 62, 2015.
ISNAD	KANIK, ALİ vd. "Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children". (2015), 58-62.

APA	KANIK A, SIRIN S, Kose E, ELİAÇIK K, ANIL M, Helvacı M (2015). Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. Turkish Neurosurgery, 25(1), 58 - 62.
Chicago	KANIK ALİ,SIRIN Seda,Kose Engin,ELİAÇIK Kayı,ANIL Murat,Helvacı Mehmet Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. Turkish Neurosurgery 25, no.1 (2015): 58 - 62.
MLA	KANIK ALİ,SIRIN Seda,Kose Engin,ELİAÇIK Kayı,ANIL Murat,Helvacı Mehmet Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. Turkish Neurosurgery, vol.25, no.1, 2015, ss.58 - 62.
AMA	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. Turkish Neurosurgery. 2015; 25(1): 58 - 62.
Vancouver	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children. Turkish Neurosurgery. 2015; 25(1): 58 - 62.
IEEE	KANIK A,SIRIN S,Kose E,ELİAÇIK K,ANIL M,Helvacı M "Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children." Turkish Neurosurgery, 25, ss.58 - 62, 2015.
ISNAD	KANIK, ALİ vd. "Clinical and Economic Results of Ventriculoperitoneal Shunt Infections in Children". Turkish Neurosurgery 25/1 (2015), 58-62.