{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T21:05:15Z","timestamp":1783803915992,"version":"3.55.0"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Readmission after an operation has garnered considerable attention within the neurosurgical literature. In this study, the authors sought to analyze the reasons why children are readmitted after shunt surgery and to identify key population characteristics and potential drivers.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n The authors\u2019 single-institution shunt surgery administrative database was used to identify procedures performed from January 1, 2018, to December 31, 2021. Only de novo or revision cranial shunt operations were included. Each surgery within the database represents an index case, and each patient was followed for a 90-day period. The authors categorized an unplanned readmission after shunt surgery as falling into one of 4 groups: 1)\n definitely unrelated<\/jats:italic>\n to the index surgery; 2)\n possibly related<\/jats:italic>\n but ultimately deemed unrelated; 3)\n directly related<\/jats:italic>\n but no return to the operating room; and 4)\n directly related<\/jats:italic>\n and requiring repeat surgery. Groups 3 and 4 were combined for statistical purposes.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n A total of 715 shunt operations were performed with 148 (20.7%) unplanned readmissions within 90 days in 139 patients. The median age was 3.2 years with 58%, 53%, and 58% being male, Caucasian, and having some form of public health insurance, respectively. The majority of African-American children had government insurance (80%) compared to Caucasian (41%) and Hispanic\/other (55%) children (p < 0.001). The proportion of new versus revision surgical procedures was 45% versus 55%. Surgeon C did the most operations (n = 52 [37%]). The median number of days to readmission and length of readmission were 26.5 (IQR 9.5\u201347.0) days and 3.0 (IQR confidence interval 1.0\u20135.0) days, respectively. Multinomial analysis found that public insurance, revision surgery, and prior admission to the neonatal intensive care unit (NICU) were associated with\n definitely unrelated<\/jats:italic>\n readmissions. Private insurance, no prior NICU admission, and an individual surgeon were associated with\n directly related<\/jats:italic>\n readmissions. Survival analyses showed no differences in time to readmission among all patients and among only those who had prior NICU admission.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The 90-day readmission rate after index shunt surgery was 21%. Drivers of readmission\u2014including socioeconomic status and hydrocephalus severity\u2014were a function of the type of readmission.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.12.peds24260","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T22:45:43Z","timestamp":1745016343000},"page":"20-28","source":"Crossref","is-referenced-by-count":1,"title":["Unplanned shunt readmission: what does it really look like?"],"prefix":"10.3171","volume":"36","author":[{"given":"Emal","family":"Lesha","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaan","family":"Yagmurlu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey, Memphis;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Shimony","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey, Memphis;"},{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandy","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Laird","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Dugan","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis;"},{"name":"Semmes Murphey, Memphis;"},{"name":"Neuroscience Institute, Le Bonheur Children\u2019s Hospital, Memphis; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"11","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"2659","article-title":"The 30-day readmission rate in neurosurgery\u2014a useful indicator for quality assessment?","volume":"162","author":"Schipmann S","year":"2020","unstructured":"Schipmann S, Suero Molina E, Windheuser J, The 30-day readmission rate in neurosurgery\u2014a useful indicator for quality assessment?. Acta Neurochir (Wien). 2020;162(11):2659\u20132669."},{"key":"b2","series-title":"World Neurosurg","first-page":"e622","article-title":"Causes and predictors of unplanned readmission in cranial neurosurgery","volume":"149","author":"Sander C","year":"2021","unstructured":"Sander C, Oppermann H, Nestler U, Sander K, von Dercks N, Meixensberger J. Causes and predictors of unplanned readmission in cranial neurosurgery. World Neurosurg. 2021;149:e622\u2013e635."},{"issue":"3","key":"b3","series-title":"Neurosurgery","first-page":"356","article-title":"Causes and timing of unplanned early readmission after neurosurgery","volume":"79","author":"Taylor BE","year":"2016","unstructured":"Taylor BE, Youngerman BE, Goldstein H, Causes and timing of unplanned early readmission after neurosurgery. Neurosurgery. 2016;79(3):356\u2013369."},{"issue":"2","key":"b4","series-title":"J Neurosurg","first-page":"342","article-title":"A systematic review of 30-day readmission after cranial neurosurgery","volume":"127","author":"Cusimano MD","year":"2017","unstructured":"Cusimano MD, Pshonyak I, Lee MY, Ilie G. A systematic review of 30-day readmission after cranial neurosurgery. J Neurosurg. 2017;127(2):342\u2013352."},{"issue":"3-4","key":"b5","series-title":"World Neurosurg","first-page":"376","article-title":"Readmissions in neurosurgery: a qualitative inquiry","volume":"82","author":"Vaziri S","year":"2014","unstructured":"Vaziri S, Cox JB, Friedman WA. Readmissions in neurosurgery: a qualitative inquiry. World Neurosurg. 2014;82(3-4):376\u2013379."},{"issue":"4","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"334","article-title":"Outcomes of CSF shunting in children: comparison of Hydrocephalus Clinical Research Network cohort with historical controls: clinical article","volume":"12","author":"Kulkarni AV","year":"2013","unstructured":"Kulkarni AV, Riva-Cambrin J, Butler J, Outcomes of CSF shunting in children: comparison of Hydrocephalus Clinical Research Network cohort with historical controls: clinical article. J Neurosurg Pediatr. 2013;12(4):334\u2013338."},{"issue":"1","key":"b7","series-title":"Neurosurgery","first-page":"123","article-title":"Shunt failure\u2014the first 30 days","volume":"87","author":"Lee RP","year":"2020","unstructured":"Lee RP, Ajmera S, Thomas F, Shunt failure\u2014the first 30 days. Neurosurgery. 2020;87(1):123\u2013129."},{"issue":"2","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"179","article-title":"Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program\u2013Pediatrics","volume":"14","author":"Piatt JH Jr","year":"2014","unstructured":"Piatt JH Jr. Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program\u2013Pediatrics. J Neurosurg Pediatr. 2014;14(2):179\u2013183."},{"issue":"1","key":"b9","series-title":"Pediatr Neurosurg","first-page":"6","article-title":"Predictors of ventriculoperitoneal shunt failure in children undergoing initial placement or revision","volume":"52","author":"Gonzalez DO","year":"2017","unstructured":"Gonzalez DO, Mahida JB, Asti L, Predictors of ventriculoperitoneal shunt failure in children undergoing initial placement or revision. Pediatr Neurosurg. 2017;52(1):6\u201312."},{"issue":"1","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"21","article-title":"Factors associated with early shunt revision within 30 days: analyses from the National Surgical Quality Improvement Program","volume":"29","author":"Alvi MA","year":"2021","unstructured":"Alvi MA, Bhandarkar AR, Daniels DJ, Miller KJ, Ahn ES. Factors associated with early shunt revision within 30 days: analyses from the National Surgical Quality Improvement Program. J Neurosurg Pediatr. 2021;29(1):21\u201330."},{"issue":"5","key":"b11","series-title":"J Neurosurg Pediatr","first-page":"553","article-title":"Readmissions after ventricular shunting in pediatric patients with hydrocephalus: a Nationwide Readmissions Database analysis","volume":"28","author":"Donoho DA","year":"2021","unstructured":"Donoho DA, Buchanan IA, Rangwala SD, Readmissions after ventricular shunting in pediatric patients with hydrocephalus: a Nationwide Readmissions Database analysis. J Neurosurg Pediatr. 2021;28(5):553\u2013562."},{"issue":"3","key":"b12","series-title":"J Neurosurg","first-page":"1210","article-title":"Readmission and reoperation for hydrocephalus: a population-based analysis across the spectrum of age","volume":"134","author":"LeHanka A","year":"2020","unstructured":"LeHanka A, Piatt J. Readmission and reoperation for hydrocephalus: a population-based analysis across the spectrum of age. J Neurosurg. 2020;134(3):1210\u20131217."},{"issue":"2","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"149","article-title":"Pediatric shunt failure: finding predictability in the sea of uncertainty","volume":"33","author":"Nadeem M","year":"2023","unstructured":"Nadeem M, Jirankali V, Singha S, Pediatric shunt failure: finding predictability in the sea of uncertainty. J Neurosurg Pediatr. 2023;33(2):149\u2013156."},{"issue":"1","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"7","article-title":"The Preventable Shunt Revision Rate: a potential quality metric for pediatric shunt surgery","volume":"18","author":"Venable GT","year":"2016","unstructured":"Venable GT, Rossi NB, Morgan Jones G, The Preventable Shunt Revision Rate: a potential quality metric for pediatric shunt surgery. J Neurosurg Pediatr. 2016;18(1):7\u201315."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"525","article-title":"Return to system within 30 days of discharge following pediatric shunt surgery","volume":"13","author":"Chern JJ","year":"2014","unstructured":"Chern JJ, Bookland M, Tejedor-Sojo J, Return to system within 30 days of discharge following pediatric shunt surgery. J Neurosurg Pediatr. 2014;13(5):525\u2013531."},{"issue":"4","key":"b16","series-title":"J Neurosurg Pediatr","first-page":"397","article-title":"Return to the emergency department after ventricular shunt evaluation","volume":"17","author":"Sarda S","year":"2016","unstructured":"Sarda S, Simon HK, Hirsh DA, Wang A, Tubbs RS, Chern JJ. Return to the emergency department after ventricular shunt evaluation. J Neurosurg Pediatr. 2016;17(4):397\u2013402."},{"issue":"11","key":"b1","series-title":"Acta Neurochir (Wien)","first-page":"2659","article-title":"The 30-day readmission rate in neurosurgery\u2014a useful indicator for quality assessment?","volume":"162","author":"Schipmann S","year":"2020","unstructured":"Schipmann S, Suero Molina E, Windheuser J, The 30-day readmission rate in neurosurgery\u2014a useful indicator for quality assessment?. Acta Neurochir (Wien). 2020;162(11):2659\u20132669."},{"key":"b2","series-title":"World Neurosurg","first-page":"e622","article-title":"Causes and predictors of unplanned readmission in cranial neurosurgery","volume":"149","author":"Sander C","year":"2021","unstructured":"Sander C, Oppermann H, Nestler U, Sander K, von Dercks N, Meixensberger J. Causes and predictors of unplanned readmission in cranial neurosurgery. World Neurosurg. 2021;149:e622\u2013e635."},{"issue":"3","key":"b3","series-title":"Neurosurgery","first-page":"356","article-title":"Causes and timing of unplanned early readmission after neurosurgery","volume":"79","author":"Taylor BE","year":"2016","unstructured":"Taylor BE, Youngerman BE, Goldstein H, Causes and timing of unplanned early readmission after neurosurgery. Neurosurgery. 2016;79(3):356\u2013369."},{"issue":"2","key":"b4","series-title":"J Neurosurg","first-page":"342","article-title":"A systematic review of 30-day readmission after cranial neurosurgery","volume":"127","author":"Cusimano MD","year":"2017","unstructured":"Cusimano MD, Pshonyak I, Lee MY, Ilie G. A systematic review of 30-day readmission after cranial neurosurgery. J Neurosurg. 2017;127(2):342\u2013352."},{"issue":"3-4","key":"b5","series-title":"World Neurosurg","first-page":"376","article-title":"Readmissions in neurosurgery: a qualitative inquiry","volume":"82","author":"Vaziri S","year":"2014","unstructured":"Vaziri S, Cox JB, Friedman WA. Readmissions in neurosurgery: a qualitative inquiry. World Neurosurg. 2014;82(3-4):376\u2013379."},{"issue":"4","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"334","article-title":"Outcomes of CSF shunting in children: comparison of Hydrocephalus Clinical Research Network cohort with historical controls: clinical article","volume":"12","author":"Kulkarni AV","year":"2013","unstructured":"Kulkarni AV, Riva-Cambrin J, Butler J, Outcomes of CSF shunting in children: comparison of Hydrocephalus Clinical Research Network cohort with historical controls: clinical article. J Neurosurg Pediatr. 2013;12(4):334\u2013338."},{"issue":"1","key":"b7","series-title":"Neurosurgery","first-page":"123","article-title":"Shunt failure\u2014the first 30 days","volume":"87","author":"Lee RP","year":"2020","unstructured":"Lee RP, Ajmera S, Thomas F, Shunt failure\u2014the first 30 days. Neurosurgery. 2020;87(1):123\u2013129."},{"issue":"2","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"179","article-title":"Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program\u2013Pediatrics","volume":"14","author":"Piatt JH Jr","year":"2014","unstructured":"Piatt JH Jr. Thirty-day outcomes of cerebrospinal fluid shunt surgery: data from the National Surgical Quality Improvement Program\u2013Pediatrics. J Neurosurg Pediatr. 2014;14(2):179\u2013183."},{"issue":"1","key":"b9","series-title":"Pediatr Neurosurg","first-page":"6","article-title":"Predictors of ventriculoperitoneal shunt failure in children undergoing initial placement or revision","volume":"52","author":"Gonzalez DO","year":"2017","unstructured":"Gonzalez DO, Mahida JB, Asti L, Predictors of ventriculoperitoneal shunt failure in children undergoing initial placement or revision. Pediatr Neurosurg. 2017;52(1):6\u201312."},{"issue":"1","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"21","article-title":"Factors associated with early shunt revision within 30 days: analyses from the National Surgical Quality Improvement Program","volume":"29","author":"Alvi MA","year":"2021","unstructured":"Alvi MA, Bhandarkar AR, Daniels DJ, Miller KJ, Ahn ES. Factors associated with early shunt revision within 30 days: analyses from the National Surgical Quality Improvement Program. J Neurosurg Pediatr. 2021;29(1):21\u201330."},{"issue":"5","key":"b11","series-title":"J Neurosurg Pediatr","first-page":"553","article-title":"Readmissions after ventricular shunting in pediatric patients with hydrocephalus: a Nationwide Readmissions Database analysis","volume":"28","author":"Donoho DA","year":"2021","unstructured":"Donoho DA, Buchanan IA, Rangwala SD, Readmissions after ventricular shunting in pediatric patients with hydrocephalus: a Nationwide Readmissions Database analysis. J Neurosurg Pediatr. 2021;28(5):553\u2013562."},{"issue":"3","key":"b12","series-title":"J Neurosurg","first-page":"1210","article-title":"Readmission and reoperation for hydrocephalus: a population-based analysis across the spectrum of age","volume":"134","author":"LeHanka A","year":"2020","unstructured":"LeHanka A, Piatt J. Readmission and reoperation for hydrocephalus: a population-based analysis across the spectrum of age. J Neurosurg. 2020;134(3):1210\u20131217."},{"issue":"2","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"149","article-title":"Pediatric shunt failure: finding predictability in the sea of uncertainty","volume":"33","author":"Nadeem M","year":"2023","unstructured":"Nadeem M, Jirankali V, Singha S, Pediatric shunt failure: finding predictability in the sea of uncertainty. J Neurosurg Pediatr. 2023;33(2):149\u2013156."},{"issue":"1","key":"b14","series-title":"J Neurosurg Pediatr","first-page":"7","article-title":"The Preventable Shunt Revision Rate: a potential quality metric for pediatric shunt surgery","volume":"18","author":"Venable GT","year":"2016","unstructured":"Venable GT, Rossi NB, Morgan Jones G, The Preventable Shunt Revision Rate: a potential quality metric for pediatric shunt surgery. J Neurosurg Pediatr. 2016;18(1):7\u201315."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"525","article-title":"Return to system within 30 days of discharge following pediatric shunt surgery","volume":"13","author":"Chern JJ","year":"2014","unstructured":"Chern JJ, Bookland M, Tejedor-Sojo J, Return to system within 30 days of discharge following pediatric shunt surgery. J Neurosurg Pediatr. 2014;13(5):525\u2013531."},{"issue":"4","key":"b16","series-title":"J Neurosurg Pediatr","first-page":"397","article-title":"Return to the emergency department after ventricular shunt evaluation","volume":"17","author":"Sarda S","year":"2016","unstructured":"Sarda S, Simon HK, Hirsh DA, Wang A, Tubbs RS, Chern JJ. Return to the emergency department after ventricular shunt evaluation. J Neurosurg Pediatr. 2016;17(4):397\u2013402."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/36\/1\/article-p20.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/36\/1\/article-p20.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/36\/1\/article-p20.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:46:30Z","timestamp":1772804790000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/36\/1\/article-p20.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":32,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2024.12.peds24260","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]}}}