{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:03:19Z","timestamp":1793995399471,"version":"4.8.0"},"reference-count":31,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UKSR participating NHS Trusts"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2019,2,10]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine current epidemiology and clinical characteristics of cerebrospinal fluid (CSF) shunt surgery, including revisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective, multicentre, registry-based study was conducted based on 10 years\u2019 data from the UK Shunt Registry, including primary and revision shunting procedures reported between 2004 and 2013. Incidence rates of primary shunts, descriptive statistics and shunt revision rates were calculated stratified by age group, geographical region and year of operation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>41 036 procedures in 26\u2009545 patients were submitted during the study period, including 3002 infants, 4389 children and 18\u2009668 adults. Procedures included 20\u2009947 (51.0%) primary shunt insertions in 20\u2009947 patients, and 20\u2009089 (49.0%) revision procedures. Incidence rates of primary shunt insertions for infants, children and adults were 39.5, 2.4 and 3.5 shunts per 100\u2009000 person-years, respectively. These varied by geographical subregion and year of operation. The most common underlying diagnoses were perinatal intraventricular haemorrhage (35.3%) and malformations (33.9%) in infants, tumours (40.5%) and malformations (16.3%) in children, and tumours (24.6%), post-haemorrhagic hydrocephalus (16.2%) and idiopathic normal pressure hydrocephalus (14.2%) in adults. Ninety-day revision rates were 21.9%, 18.6% and 12.8% among infants, children and adults, respectively, while first-year revision rates were 31.0%, 25.2% and 17.4%. The main reasons for revision were underdrainage and infection, but overdrainage and mechanical failure continue to pose problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our report informs patients, carers, clinicians, providers and commissioners of healthcare, researchers and industry of the current epidemiology of shunting for CSF disorders, including the potential risks of complications and frequency of revision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2018-319927","type":"journal-article","created":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T17:15:44Z","timestamp":1553534144000},"page":"747-754","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":75,"title":["Current epidemiology of cerebrospinal fluid shunt surgery in the UK and Ireland (2004\u20132013)"],"prefix":"10.1136","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4989-0687","authenticated-orcid":false,"given":"Roc\u00edo","family":"Fern\u00e1ndez-M\u00e9ndez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh K","family":"Richards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen M","family":"Seeley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Pickard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis J","family":"Joannides","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,25]]},"reference":[{"key":"2024120416214254000_90.7.747.1","first-page":"1","article-title":"Global hydrocephalus epidemiology and incidence: systematic review and meta-analysis","volume":"37","author":"Dewan","year":"2018","journal-title":"J Neurosurg"},{"key":"2024120416214254000_90.7.747.2","doi-asserted-by":"crossref","first-page":"547","DOI":"10.3171\/2009.7.PEDS08371","article-title":"Congenital hydrocephalus and ventriculoperitoneal shunts: influence of etiology and programmable shunts on revisions","volume":"61","author":"Notarianni","year":"2009","journal-title":"J Neurosurg Pediatr"},{"key":"2024120416214254000_90.7.747.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-311302"},{"key":"2024120416214254000_90.7.747.4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3171\/PED-08\/01\/040","article-title":"Have we made progress in preventing shunt failure? 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