{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:41:56Z","timestamp":1792204916934,"version":"4.4.0"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n CSF shunt placement is the primary therapy for hydrocephalus; however, shunt malfunctions remain common and lead to neurological deficits if missed. There is a lack of literature characterizing the epidemiology of children with possible shunt malfunctions presenting to United States emergency departments (EDs).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n A retrospective study was conducted of the 2006\u20132017 National Emergency Department Sample. The data were queried using an exhaustive list of Current Procedural Terminology and\n International Classification of Diseases, Ninth Revision<\/jats:italic>\n and\n International Classification of Diseases, Tenth Revision<\/jats:italic>\n codes representing children with hydrocephalus diagnoses, diagnostic imaging for shunt malfunctions, and shunt-related surgical revision procedures.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n In 2017, there were an estimated 16,376 ED visits for suspected shunt malfunction. Children were more commonly male (57.9%), ages 0\u20134 years (42.2%), and publicly insured (55.8%). Many did not undergo diagnostic imaging (37.2%), and of those who did, most underwent head CT scans (43.7%). Between 2006 and 2017, pediatric ED visits for suspected shunt malfunction increased 18% (95% CI 12.1\u201323.8). The use of MRI increased substantially (178.0%, 95% CI 176.9\u2013179.2). Visits resulting in discharge home from the ED increased by 76.3% (95% CI 73.1\u201379.4), and those involving no surgical intervention increased by 32.9% (95% CI 29.2\u201336.6).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Between 2006 and 2017, ED visits for children to rule out shunt malfunction increased, yet there was a decline in surgical intervention and an increase in discharges home from the ED. Possible contributing factors include improved clinical criteria for shunt evaluation, alternative CSF diversion techniques, changing indications for shunt placement, and increased use of advanced imaging in the ED.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.6.peds19729","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T03:09:14Z","timestamp":1603422554000},"page":"23-29","source":"Crossref","is-referenced-by-count":9,"title":["United States emergency department visits for children with cerebrospinal fluid shunts"],"prefix":"10.3171","volume":"27","author":[{"given":"Amrita","family":"Hari-Raj","sequence":"first","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren Q.","family":"Malthaner","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junxin","family":"Shi","sequence":"additional","affiliation":[{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Leonard","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus;"},{"name":"Division of Pediatric Neurosurgery, Nationwide Children\u2019s Hospital, Columbus; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C.","family":"Leonard","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus;"},{"name":"The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus;"},{"name":"Division of Pediatric Emergency Medicine, Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Clin Infect Dis","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1086\/368191","article-title":"Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens","volume":"36","author":"McGirt MJ","year":"2003","unstructured":"McGirt MJ, Zaas A, Fuchs HE, Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. 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