{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:07:44Z","timestamp":1792516064473,"version":"4.5.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The aims of this study were to quantify inpatient healthcare costs, describe patient demographics, and analyze variables influencing costs for pediatric and adult hydrocephalus shunt-related admissions in the US.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A cross-sectional study was performed using the 2019 Healthcare Cost and Utilization Project Kids\u2019 Inpatient Database (KID) and National Inpatient Sample (NIS), nationally representative weighted data sets of hospital discharges for pediatric and adult patients, respectively. <jats:italic>International Classification of Diseases, 10th Revision, Clinical Modification <\/jats:italic>and <jats:italic>Procedure Coding System<\/jats:italic> (ICD-10-CM\/PCS) code filters for data extraction were queried for admission information. Age at admission was categorized into five groups (\u2264 28 days, 29 days to &lt; 1 year, 1\u201318 years, 19\u201364 years, and \u2265 65 years).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In 2019, there were 36,898 shunt-related hospital admissions accounting for 495,138 hospital days and a total cost of more than $2.06 billion. Initial shunt placements accounted for 53.5% of all admissions and nearly 60% of the total cost.<\/jats:p>\n<jats:p>The median cost per admission was $22,700 and the median length of stay was 5 days. Admissions for shunt infection requiring revision had the highest median cost at $71,300 (p &lt; 0.001) and the longest median length of stay at 25 days (p &lt; 0.001) compared with initial shunt placements.<\/jats:p>\n<jats:p>By age, admissions that occurred in the first 28 days of life cost almost 5 times more than the median, $110,500 versus $22,700, respectively, and resulted in hospital stays that were 8 times longer than the median, 41 versus 5 days, respectively. Individuals aged \u2265 65 years accounted for 28% of the total shunt-related admissions.<\/jats:p>\n<jats:p>Almost two-thirds (65.3%) of shunt-related admissions were classified as nonelective. The median cost of nonelective procedures was double that of elective admissions, $33,900 versus $15,100, respectively (p &lt; 0.001), and resulted in almost 5 times longer hospital stays, 9 versus 2 days, respectively (p &lt; 0.001).<\/jats:p>\n<jats:p>Shunt-related admissions were predominantly male across all age groups (54.7%\u201357.4% male) except the 19- to 64-year age group. In the 19- to 64-year age group, females accounted for 51.1% of admissions. Insurance status was largely age dependent. Of all admissions, 33.1% used private insurance, 32.9% Medicare, and 27.7% Medicaid.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This is the first study to quantify the patient demographics and cost of hydrocephalus shunt-related admissions across the entire age spectrum. Shunt-related admissions cost the US more than $2.06 billion dollars per year and represent only a fraction of the total cost of hydrocephalus care.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.10.jns22330","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T11:16:36Z","timestamp":1671794196000},"page":"502-511","source":"Crossref","is-referenced-by-count":21,"title":["Inpatient healthcare burden and variables influencing hydrocephalus-related admissions across the lifespan"],"prefix":"10.3171","volume":"139","author":[{"given":"Jenna E.","family":"Koschnitzky","sequence":"first","affiliation":[{"name":"Research Department, Hydrocephalus Association, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Yap","sequence":"additional","affiliation":[{"name":"Rhaeos, Inc., Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica J.","family":"Chau","sequence":"additional","affiliation":[{"name":"Research Department, Hydrocephalus Association, Bethesda, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketan","family":"Yerneni","sequence":"additional","affiliation":[{"name":"Rhaeos, Inc., Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Lisa","family":"Somera","sequence":"additional","affiliation":[{"name":"Rhaeos, Inc., Chicago, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Luciano","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Moghekar","sequence":"additional","affiliation":[{"name":"Neurology, Johns Hopkins Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Yale J Biol Med","first-page":"313","article-title":"A review of cerebral shunts, current technologies, and future endeavors","volume":"91","author":"Soler GJ","year":"2018","unstructured":"Soler GJ, Bao M, Jaiswal D,  A review of cerebral shunts, current technologies, and future endeavors. 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