{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:34:25Z","timestamp":1783776865177,"version":"3.55.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Ventricular shunts for pediatric hydrocephalus continue to be plagued with high failure rates. Reported risk factors for shunt failure are inconsistent and controversial. The raw or global shunt revision rate has been the foundation of several proposed quality metrics. The authors undertook this study to determine risk factors for shunt revision within their own patient population.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>In this single-center retrospective cohort study, a database was created of all ventricular shunt operations performed at the authors\u2019 institution from January 1, 2010, through December 2013. For each index shunt surgery, demographic, clinical, and procedural variables were assembled. An \u201cindex surgery\u201d was defined as implantation of a new shunt or the revision or augmentation of an existing shunt system. Bivariate analyses were first performed to evaluate individual effects of each independent variable on shunt failure at 90 days and at 180 days. A final multivariate model was chosen for each outcome by using a backward model selection approach.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 466 patients in the study accounting for 739 unique (\u201cindex\u201d) operations, for an average of 1.59 procedures per patient. The median age for the cohort at the time of the first shunt surgery was 5 years (range 0\u201335.7 years), with 53.9% males. The 90- and 180-day shunt failure rates were 24.1% and 29.9%, respectively. The authors found no variable\u2014demographic, clinical, or procedural\u2014that predicted shunt failure within 90 or 180 days.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In this study, none of the risk factors that were examined were statistically significant in determining shunt failure within 90 or 180 days. Given the negative findings and the fact that all other risk factors for shunt failure that have been proposed in the literature thus far are beyond the control of the surgeon (i.e., nonmodifiable), the use of an institution\u2019s or individual\u2019s global shunt revision rate remains questionable and needs further evaluation before being accepted as a quality metric.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.5.peds15118","type":"journal-article","created":{"date-parts":[[2015,11,6]],"date-time":"2015-11-06T15:04:57Z","timestamp":1446822297000},"page":"249-259","source":"Crossref","is-referenced-by-count":21,"title":["Predicting shunt failure in children: should the global shunt revision rate be a quality measure?"],"prefix":"10.3171","volume":"17","author":[{"given":"Nicholas B.","family":"Rossi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nickalus R.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamekia L.","family":"Jones","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Children\u2019s Foundation Research Institute;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Lepard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama, Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph H.","family":"McAbee","sequence":"additional","affiliation":[{"name":"School of Medicine, Wake Forest University, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center;"},{"name":"Semmes-Murphey Neurologic & Spine Institute; and"},{"name":"Le Bonheur Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 1","key":"b1-peds15118","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3171\/2014.7.PEDS14325","article-title":"Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. 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