{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:40:53Z","timestamp":1791110453278,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002317"],"award-info":[{"award-number":["KL2 TR002317"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To clarify the extent to which medical comorbidities and goals\u2010of\u2010care decisions influence death among individuals with childhood\u2010onset hydrocephalus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This was a retrospective cohort study of 1705 individuals (759 males, 946 females, mean age 11y 5mo, SD 6y 6mo, range 0\u201337y 7mo at last follow\u2010up) with childhood\u2010onset hydrocephalus, of whom 88 (5.2%) were deceased. Existing medical records, death records, and publicly available internet sources were analyzed. We estimated hazard ratios for putative risk factors through Cox regression based upon 10\u2009529 person\u2010years of data and quantitatively and qualitatively analyzed the circumstances surrounding each death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mortality did not differ statistically by demographic factors, although higher proportions of non\u2010White and Hispanic individuals were deceased. Most deaths were related to medical comorbidities rather than hydrocephalus itself. Of the 14 deaths directly related to hydrocephalus, seven were caused by shunt complications and four occurred after decisions to forgo treatment, apparently in response to poor outcomes predicted by the medical team. Half the deaths were preceded by shifts to comfort\u2010based care; however, these decisions appeared to substantially change the patient\u2019s clinical trajectory only half the time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Children are more likely to die with, rather than from, hydrocephalus. Our results emphasize the complexities of medical decision\u2010making and the influence of clinicians in guiding these choices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.14975","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:43:02Z","timestamp":1626396182000},"page":"112-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Mortality in pediatric hydrocephalus"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3826-3204","authenticated-orcid":false,"given":"Hannah M","family":"Tully","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology Seattle Children\u2019s Hospital Seattle WA USA"},{"name":"Department of Neurology University of Washington Seattle WA USA"},{"name":"Center for Integrated Brain Research Seattle Children\u2019s Research Institute Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Doherty","sequence":"additional","affiliation":[{"name":"Center for Integrated Brain Research Seattle Children\u2019s Research Institute Seattle WA USA"},{"name":"Department of Pediatrics Seattle Children\u2019s Hospital Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology Seattle Children\u2019s Hospital Seattle WA USA"},{"name":"Department of Neurology University of Washington Seattle WA USA"},{"name":"Center for Integrated Brain Research Seattle Children\u2019s Research Institute Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2011.03.009"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmg.2014.06.002"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.37.194.345"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003810050186"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-016-3268-y"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-010-1131-0"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000121229"},{"issue":"5","key":"e_1_2_10_9_1","first-page":"442","article-title":"Predictors of death in pediatric patients requiring cerebrospinal fluid shunts","volume":"100","author":"Tuli S","year":"2004","journal-title":"J Neurosurg"},{"key":"e_1_2_10_10_1","first-page":"47","article-title":"The outcome of shunted hydrocephalic children","volume":"64","author":"Kao CL","year":"2001","journal-title":"Zhonghua Yi Xue Za Zhi (Taipei)"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3171\/2010.9.PEDS09548"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejpn.2001.0555"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.5.PEDS14532"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-018-1021-2"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000700"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2008.01353.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-013-1146-1"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-8118-9-18"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000149904"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1085463"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.PEDS15106"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/2018.7.FOCUS18272"}],"container-title":["Developmental Medicine &amp; 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