{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:40:55Z","timestamp":1791110455937,"version":"4.1.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Several studies of administrative data have noted higher mortality rates for Black\/African American children with shunted hydrocephalus. A longitudinal study of children with hydrocephalus secondary to myelomeningocele showed lower lifetime rates of shunt revision in minority children compared to White children, indicating a possible disparity in hydrocephalus treatment. The goal of this study is to identify racial and ethnic disparities in mortality or in shunt revision rates by using the Hydrocephalus Clinical Research Network (HCRN) hydrocephalus registry sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The HCRN registry was queried for patients with shunted hydrocephalus for whom data on all lifetime hydrocephalus procedures were available. Patients with a primary shunt placement prior to 2023 were included, with follow-up extending through March 19, 2024. A Cox proportional hazards model was created to determine the effect of race and ethnicity on mortality while controlling for age at initial shunt placement, sex, hydrocephalus etiology, gestational age at birth, and presence of complex chronic conditions. Similarly, a proportional means model was used to evaluate association with lifetime number of shunt revision surgeries. The authors\u2019 hypothesis was that when controlling for other variables, minority children would have higher mortality and fewer shunt revision surgeries than White children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 5656 children were included in the analysis of mortality. There were 579 deaths. Race and ethnicity were independently associated with mortality, with Black (HR 1.32, 95% CI 1.05\u20131.65), other non-White (HR 1.39, 95% CI 1.03\u20131.86), and Hispanic (HR 1.50, 95% CI 1.22\u20131.84) children having a higher mortality rate than White children. In the analysis of 4081 children with shunts, Hispanic ethnicity was also independently associated with fewer total shunt revisions (HR 0.84, 95% CI 0.72\u20130.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In children with hydrocephalus, when controlling for other factors, there is a higher mortality rate among Hispanic, Black, and other non-White children, and fewer shunt revisions among Hispanic children. These findings highlight important potential disparities in hydrocephalus treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.12.peds24371","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T13:05:34Z","timestamp":1742648734000},"page":"554-562","source":"Crossref","is-referenced-by-count":4,"title":["Racial disparities in hydrocephalus mortality and shunt revision: a study from the Hydrocephalus Clinical Research Network"],"prefix":"10.3171","volume":"35","author":[{"given":"Brandon G.","family":"Rocque","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s of Alabama, The University of Alabama at Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Jensen","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron W.","family":"Reeder","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Rozzelle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s of Alabama, The University of Alabama at Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhaya V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F.","family":"Pollack","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"McDowell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, UPMC Children\u2019s Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Naftel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Surgical Outcomes Center for Kids, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt University, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A.","family":"Pindrik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert M.","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Strahle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Washington University School of Medicine in St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, British Columbia Children\u2019s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S.","family":"Tamber","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, British Columbia Children\u2019s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd C.","family":"Hankinson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s Hospital Colorado, Aurora, Colorado;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Browd","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S.","family":"Hauptman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Phoenix Children\u2019s Hospital, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Krieger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Children\u2019s Hospital Los Angeles, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Riley Children\u2019s Hospital, Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Riva-Cambrin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Alberta Children\u2019s Hospital, University of Calgary, Alberta, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Limbrick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Holubkov","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R. W.","family":"Kestle","sequence":"additional","affiliation":[{"name":"Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Wellons","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Surgical Outcomes Center for Kids, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt University, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurosurg Pediatr","first-page":"131","article-title":"Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths","volume":"1","author":"Simon TD","year":"2008","unstructured":"Simon TD, Riva-Cambrin J, Srivastava R, Bratton SL, Dean JM, Kestle JR. Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. J Neurosurg Pediatr. 2008;1(2):131-137."},{"issue":"10020","key":"b2","series-title":"Lancet","first-page":"788","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle KT","year":"2016","unstructured":"Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799."},{"issue":"6 Suppl","key":"b3","series-title":"J Neurosurg","first-page":"474","article-title":"Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus","volume":"107","author":"Piatt JH Jr","year":"2007","unstructured":"Piatt JH Jr, Cosgriff M. Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus. J Neurosurg. 2007;107(6 Suppl):474-478."},{"issue":"1","key":"b4","series-title":"Dev Med Child Neurol","first-page":"112","article-title":"Mortality in pediatric hydrocephalus","volume":"64","author":"Tully HM","year":"2022","unstructured":"Tully HM, Doherty D, Wainwright M. Mortality in pediatric hydrocephalus. Dev Med Child Neurol. 2022;64(1):112\u2013117."},{"issue":"1","key":"b5","series-title":"Fluids Barriers CNS","first-page":"18","article-title":"Pediatric hydrocephalus outcomes: a review","volume":"9","author":"Vinchon M","year":"2012","unstructured":"Vinchon M, Rekate H, Kulkarni AV. Pediatric hydrocephalus outcomes: a review. Fluids Barriers CNS. 2012;9(1):18."},{"issue":"2 Suppl","key":"b6","series-title":"J Neurosurg","first-page":"113","article-title":"Time trends and demographics of deaths from congenital hydrocephalus in children in the United States: National Center for Health Statistics data, 1979 to 1998.","volume":"103","author":"Chi JH","year":"2005","unstructured":"Chi JH, Fullerton HJ, Gupta N. Time trends and demographics of deaths from congenital hydrocephalus in children in the United States: National Center for Health Statistics data, 1979 to 1998.J Neurosurg. 2005;103(2 Suppl):113-118."},{"key":"b7","series-title":"World Neurosurg","first-page":"399","article-title":"Cross-sectional analysis on racial and economic disparities affecting mortality in preterm infants with posthemorrhagic hydrocephalus","volume":"88","author":"Jin DL","year":"2016","unstructured":"Jin DL, Christian EA, Attenello F,  Cross-sectional analysis on racial and economic disparities affecting mortality in preterm infants with posthemorrhagic hydrocephalus. World Neurosurg. 2016;88:399\u2013410."},{"issue":"6","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"560","article-title":"Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures","volume":"15","author":"Attenello FJ","year":"2015","unstructured":"Attenello FJ, Ng A, Wen T,  Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures. J Neurosurg Pediatr. 2015;15(6):560\u2013566."},{"issue":"5","key":"b9","series-title":"J Neurosurg Pediatr","first-page":"484","article-title":"Time to shunt failure in children with myelomeningocele: an analysis of the National Spina Bifida Patient Registry","volume":"30","author":"Rocque BG","year":"2022","unstructured":"Rocque BG, Hopson B, Shamblin I,  Time to shunt failure in children with myelomeningocele: an analysis of the National Spina Bifida Patient Registry. J Neurosurg Pediatr. 2022;30(5):484\u2013489."},{"issue":"5","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"552","article-title":"The association between race and frequent shunt failure: a single-center study","volume":"11","author":"Naftel RP","year":"2013","unstructured":"Naftel RP, Safiano NA, Falola M, Blount JP, Oakes WJ, Wellons JC III. The association between race and frequent shunt failure: a single-center study. J Neurosurg Pediatr. 2013;11(5):552-557."},{"issue":"5","key":"b11","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):525-531."},{"issue":"3","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"249","article-title":"Predicting shunt failure in children: should the global shunt revision rate be a quality measure?","volume":"17","author":"Rossi NB","year":"2016","unstructured":"Rossi NB, Khan NR, Jones TL, Lepard J, McAbee JH, Klimo P Jr. Predicting shunt failure in children: should the global shunt revision rate be a quality measure?. J Neurosurg Pediatr. 2016;17(3):249\u2013259."},{"issue":"3","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"269","article-title":"Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project","volume":"27","author":"Tamber MS","year":"2020","unstructured":"Tamber MS, Kestle JRW, Reeder RW,  Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project. J Neurosurg Pediatr. 2020;27(3):269\u2013276."},{"issue":"4","key":"b14","series-title":"Am J Public Health","first-page":"634","article-title":"Health status and health service access and use among children in U.S. immigrant families","volume":"96","author":"Huang ZJ","year":"2006","unstructured":"Huang ZJ, Yu SM, Ledsky R. Health status and health service access and use among children in U.S. immigrant families. Am J Public Health. 2006;96(4):634-640."},{"issue":"5","key":"b15","series-title":"Health Aff (Millwood)","first-page":"1258","article-title":"Immigrants and health care: sources of vulnerability","volume":"26","author":"Derose KP","year":"2007","unstructured":"Derose KP, Escarce JJ, Lurie N. Immigrants and health care: sources of vulnerability. Health Aff (Millwood). 2007;26(5):1258\u20131268."},{"issue":"8","key":"b16","series-title":"Acad Emerg Med","first-page":"895","article-title":"A systematic review of the impact of physician implicit racial bias on clinical decision making","volume":"24","author":"Dehon E","year":"2017","unstructured":"Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A systematic review of the impact of physician implicit racial bias on clinical decision making. Acad Emerg Med. 2017;24(8):895-904."},{"issue":"5","key":"b17","series-title":"Neurosurgery","first-page":"1066","article-title":"The impact of social determinants of health in pediatric shunted hydrocephalus","volume":"92","author":"Khalid SI","year":"2023","unstructured":"Khalid SI, Hunter BM, Shah P,  The impact of social determinants of health in pediatric shunted hydrocephalus. Neurosurgery. 2023;92(5):1066-1072."},{"issue":"2","key":"b1","series-title":"J Neurosurg Pediatr","first-page":"131","article-title":"Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths","volume":"1","author":"Simon TD","year":"2008","unstructured":"Simon TD, Riva-Cambrin J, Srivastava R, Bratton SL, Dean JM, Kestle JR. Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. J Neurosurg Pediatr. 2008;1(2):131-137."},{"issue":"10020","key":"b2","series-title":"Lancet","first-page":"788","article-title":"Hydrocephalus in children","volume":"387","author":"Kahle KT","year":"2016","unstructured":"Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799."},{"issue":"6 Suppl","key":"b3","series-title":"J Neurosurg","first-page":"474","article-title":"Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus","volume":"107","author":"Piatt JH Jr","year":"2007","unstructured":"Piatt JH Jr, Cosgriff M. Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus. J Neurosurg. 2007;107(6 Suppl):474-478."},{"issue":"1","key":"b4","series-title":"Dev Med Child Neurol","first-page":"112","article-title":"Mortality in pediatric hydrocephalus","volume":"64","author":"Tully HM","year":"2022","unstructured":"Tully HM, Doherty D, Wainwright M. Mortality in pediatric hydrocephalus. Dev Med Child Neurol. 2022;64(1):112\u2013117."},{"issue":"1","key":"b5","series-title":"Fluids Barriers CNS","first-page":"18","article-title":"Pediatric hydrocephalus outcomes: a review","volume":"9","author":"Vinchon M","year":"2012","unstructured":"Vinchon M, Rekate H, Kulkarni AV. Pediatric hydrocephalus outcomes: a review. Fluids Barriers CNS. 2012;9(1):18."},{"issue":"2 Suppl","key":"b6","series-title":"J Neurosurg","first-page":"113","article-title":"Time trends and demographics of deaths from congenital hydrocephalus in children in the United States: National Center for Health Statistics data, 1979 to 1998.","volume":"103","author":"Chi JH","year":"2005","unstructured":"Chi JH, Fullerton HJ, Gupta N. Time trends and demographics of deaths from congenital hydrocephalus in children in the United States: National Center for Health Statistics data, 1979 to 1998.J Neurosurg. 2005;103(2 Suppl):113-118."},{"key":"b7","series-title":"World Neurosurg","first-page":"399","article-title":"Cross-sectional analysis on racial and economic disparities affecting mortality in preterm infants with posthemorrhagic hydrocephalus","volume":"88","author":"Jin DL","year":"2016","unstructured":"Jin DL, Christian EA, Attenello F,  Cross-sectional analysis on racial and economic disparities affecting mortality in preterm infants with posthemorrhagic hydrocephalus. World Neurosurg. 2016;88:399\u2013410."},{"issue":"6","key":"b8","series-title":"J Neurosurg Pediatr","first-page":"560","article-title":"Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures","volume":"15","author":"Attenello FJ","year":"2015","unstructured":"Attenello FJ, Ng A, Wen T,  Racial and socioeconomic disparities in outcomes following pediatric cerebrospinal fluid shunt procedures. J Neurosurg Pediatr. 2015;15(6):560\u2013566."},{"issue":"5","key":"b9","series-title":"J Neurosurg Pediatr","first-page":"484","article-title":"Time to shunt failure in children with myelomeningocele: an analysis of the National Spina Bifida Patient Registry","volume":"30","author":"Rocque BG","year":"2022","unstructured":"Rocque BG, Hopson B, Shamblin I,  Time to shunt failure in children with myelomeningocele: an analysis of the National Spina Bifida Patient Registry. J Neurosurg Pediatr. 2022;30(5):484\u2013489."},{"issue":"5","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"552","article-title":"The association between race and frequent shunt failure: a single-center study","volume":"11","author":"Naftel RP","year":"2013","unstructured":"Naftel RP, Safiano NA, Falola M, Blount JP, Oakes WJ, Wellons JC III. The association between race and frequent shunt failure: a single-center study. J Neurosurg Pediatr. 2013;11(5):552-557."},{"issue":"5","key":"b11","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):525-531."},{"issue":"3","key":"b12","series-title":"J Neurosurg Pediatr","first-page":"249","article-title":"Predicting shunt failure in children: should the global shunt revision rate be a quality measure?","volume":"17","author":"Rossi NB","year":"2016","unstructured":"Rossi NB, Khan NR, Jones TL, Lepard J, McAbee JH, Klimo P Jr. Predicting shunt failure in children: should the global shunt revision rate be a quality measure?. J Neurosurg Pediatr. 2016;17(3):249\u2013259."},{"issue":"3","key":"b13","series-title":"J Neurosurg Pediatr","first-page":"269","article-title":"Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project","volume":"27","author":"Tamber MS","year":"2020","unstructured":"Tamber MS, Kestle JRW, Reeder RW,  Temporal trends in surgical procedures for pediatric hydrocephalus: an analysis of the Hydrocephalus Clinical Research Network Core Data Project. J Neurosurg Pediatr. 2020;27(3):269\u2013276."},{"issue":"4","key":"b14","series-title":"Am J Public Health","first-page":"634","article-title":"Health status and health service access and use among children in U.S. immigrant families","volume":"96","author":"Huang ZJ","year":"2006","unstructured":"Huang ZJ, Yu SM, Ledsky R. Health status and health service access and use among children in U.S. immigrant families. Am J Public Health. 2006;96(4):634-640."},{"issue":"5","key":"b15","series-title":"Health Aff (Millwood)","first-page":"1258","article-title":"Immigrants and health care: sources of vulnerability","volume":"26","author":"Derose KP","year":"2007","unstructured":"Derose KP, Escarce JJ, Lurie N. Immigrants and health care: sources of vulnerability. Health Aff (Millwood). 2007;26(5):1258\u20131268."},{"issue":"8","key":"b16","series-title":"Acad Emerg Med","first-page":"895","article-title":"A systematic review of the impact of physician implicit racial bias on clinical decision making","volume":"24","author":"Dehon E","year":"2017","unstructured":"Dehon E, Weiss N, Jones J, Faulconer W, Hinton E, Sterling S. A systematic review of the impact of physician implicit racial bias on clinical decision making. Acad Emerg Med. 2017;24(8):895-904."},{"issue":"5","key":"b17","series-title":"Neurosurgery","first-page":"1066","article-title":"The impact of social determinants of health in pediatric shunted hydrocephalus","volume":"92","author":"Khalid SI","year":"2023","unstructured":"Khalid SI, Hunter BM, Shah P,  The impact of social determinants of health in pediatric shunted hydrocephalus. 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