{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:03:33Z","timestamp":1789038213518,"version":"build-2803163510"},"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":[[2025,11,7]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors provide an updated analysis of inpatient healthcare utilization, associated costs, and mortality trends for pediatric hydrocephalus in the US from 2006 to 2019. The goals were to describe patient, hospital, and hospitalization characteristics and determine factors associated with mortality.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This cross-sectional study used 2006, 2009, 2012, 2016, and 2019 data from the Healthcare Cost and Utilization Project Kids\u2019 Inpatient Database, which collects nationally representative weighted data samples of pediatric hospital discharges. Admissions related to hydrocephalus were categorized as being associated with permanent cerebrospinal fluid (CSF) diversion (including CSF shunt management and endoscopic third ventriculostomy [ETV] with or without choroid plexus cauterization [CPC]) or unrelated to permanent CSF diversion.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Each year, there were approximately 30,000\u201332,000 hydrocephalus-related admissions, resulting in 331,000\u2013526,000 hospital days and US$3.4\u20135.0 billion charges, for pediatric patients. In 2019, hydrocephalus accounted for 0.5% of all pediatric hospital admissions, 1.4% of all pediatric hospital days, and 2.4% of all pediatric hospital charges in the US. The median (IQR) length of stay across all hydrocephalus-related admissions decreased from 4 (2\u201315) days in 2006 to 3 (2\u20139) days in 2019. CSF shunt\u2013related admissions decreased from 11,111 in 2006 to 7959 in 2016; notably, admissions for CSF shunt malfunctions\/revisions decreased over time (12,327 in 2006 to 5960 in 2019). In 2019, hospital stays were shorter (4.99 vs 6.69 days) and charges were lower (US$108 million vs US$128 million) in patients who underwent ETV or ETV+CPC compared to those who had initial shunt placement, respectively. However, these unadjusted differences likely reflect baseline patient selection rather than inherent procedural superiority. Patients admitted for periventricular-intraventricular hemorrhage of prematurity (pIVH) had longer hospital stays (p < 0.001) and higher mean costs than others. Compared with survivors, children who died were younger, had pIVH, had a birth-related admission, were self-paying, and were admitted to a nonchildren\u2019s hospital (p < 0.05).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Pediatric hydrocephalus continues to pose a heavy burden in the US. Despite advancements in management, it remains associated with high costs, significant hospital utilization, and substantial morbidity and mortality. ETV admissions were associated with shorter hospital stays and lower costs, and pIVH was associated with particularly high resource utilization and markedly higher in-hospital mortality. Future efforts should focus on reducing mortality and improving care delivery for high-risk subgroups, particularly those with pIVH and birth-related etiologies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.7.peds25257","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T02:09:54Z","timestamp":1762567794000},"page":"77-86","source":"Crossref","is-referenced-by-count":1,"title":["Hospital care for children with hydrocephalus in the United States: resource utilization, charges, comorbidities, and deaths (2006\u20132019)"],"prefix":"10.3171","volume":"37","author":[{"given":"Muhammad S.","family":"Ghauri","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Brandel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R. W.","family":"Kestle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"},{"name":"Division of Pediatric Neurosurgery, Primary Children\u2019s Hospital, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay K.","family":"Riva-Cambrin","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Section of Pediatric Neurosurgery, University of Calgary, Alberta, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Whitehead","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay M.","family":"Ravindra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah;"},{"name":"Division of Pediatric Neurosurgery, Primary Children\u2019s Hospital, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Pediatr Neurol","first-page":"83","article-title":"Failure of cerebrospinal fluid shunts: Part I: obstruction and mechanical failure","volume":"34","author":"Browd SR","year":"2006","unstructured":"Browd SR, Ragel BT, Gottfried ON, Kestle JR. Failure of cerebrospinal fluid shunts: Part I: obstruction and mechanical failure. Pediatr Neurol. 2006;34(2):83\u201392."},{"issue":"5","key":"b2","series-title":"Pediatr Neurosurg","first-page":"248","article-title":"Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience","volume":"36","author":"McGirt MJ","year":"2002","unstructured":"McGirt MJ, Leveque JC, Wellons JC, Cerebrospinal fluid shunt survival and etiology of failures: a seven-year institutional experience. Pediatr Neurosurg. 2002;36(5):248\u2013255."},{"issue":"2","key":"b3","series-title":"J Neurosurg","first-page":"195","article-title":"Cerebrospinal fluid shunt infection: a prospective study of risk factors","volume":"94","author":"Kulkarni AV","year":"2001","unstructured":"Kulkarni AV, Drake JM, Lamberti-Pasculli M. Cerebrospinal fluid shunt infection: a prospective study of risk factors. J Neurosurg. 2001;94(2):195\u2013201."},{"issue":"7","key":"b4","series-title":"Clin Infect Dis","first-page":"858","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, George TM, Kaye K, Sexton DJ. Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. Clin Infect Dis. 2003;36(7):858\u2013862."},{"issue":"2","key":"b5","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 JRW. Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. 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