{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:00:37Z","timestamp":1790391637807,"version":"4.1.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,24]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Previous research has identified an association of socioeconomic status with poor health outcomes related to the treatment of pediatric hydrocephalus. However, the impact of environmental exposures and neighborhood disadvantage remains unexplored. The authors sought to determine how these factors affect hydrocephalus outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This study is an analysis of prospectively collected registry data of pediatric hydrocephalus patients from 2008 to 2023 at a single institution. Geospatial analysis was conducted using the patient\u2019s address at the time of the initial procedure for treatment of hydrocephalus. Socioeconomic status was quantified using the Area Deprivation Index (ADI), and environmental exposure data were obtained from the Centers for Disease Control and Prevention\/Agency for Toxic Substances and Disease Registry and satellite-derived ground-level fine particulate matter, linked to patients\u2019 addresses using hospital administrative data. Multivariable Cox regressions with robust standard errors to adjust for clustering of area-level measures were utilized to assess the independent association of neighborhood and environmental factors with shunt revisions and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      In total, 881 patients who underwent primary shunt insertion for nontraumatic etiologies were included. The median (IQR) ADI percentile was 78 (61\u201390). The most common hydrocephalus etiology was intraventricular hemorrhage of prematurity (33%), followed by myelomeningocele (12%). At the latest follow-up, 48% of patients had experienced at least one shunt failure. The median (IQR) follow-up duration was 5.6 (1\u201311) years. In a multivariable Cox proportional hazards model, high ozone exposure areas (HR 1.38, 95% CI 1.05\u20131.82) and high ADI (HR 1.46, 95% CI 1.15\u20131.86) were independently associated with an increased risk of failure. High coal exposure was associated with an increased risk of shunt infection (HR 1.92, 95% CI 1.28\u20132.88). High PM\n                      <jats:sub>2.5<\/jats:sub>\n                      (particulate matter with a diameter \u2264 2.5 \u03bcm) was also significantly associated with increased all-cause mortality (HR 3.16, 95% CI 1.11\u20138.99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Exposure to environmental toxins and elevated neighborhood disadvantage are associated with worse outcomes in children with hydrocephalus. Environmental exposure may increase inflammatory pathways in children and reflect poor socioeconomic status. These results highlight social and environmental risk factors that warrant further investigation through biochemical or qualitative means.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.3.peds2615","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:01:37Z","timestamp":1784678497000},"page":"1-12","source":"Crossref","is-referenced-by-count":0,"title":["The association of environmental exposures and area-level socioeconomic status with pediatric hydrocephalus outcomes"],"prefix":"10.3171","author":[{"given":"Yifei","family":"Sun","sequence":"first","affiliation":[{"name":"Heersink School of Medicine, University of Alabama at Birmingham;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather H.","family":"Johnson","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alabama at Birmingham;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Arynchyna-Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Rozzelle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P.","family":"Blount","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon G.","family":"Rocque","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Alabama at Birmingham, Alabama; and"}],"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\u2013137. doi:10.3171\/PED\/2008\/1\/2\/131"},{"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, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788\u2013799. doi:10.1016\/S0140-6736(15)60694-8"},{"issue":"8","key":"b3","series-title":"Eur J Med Genet","first-page":"359","article-title":"Infantile hydrocephalus: a review of epidemiology, classification and causes","volume":"57","author":"Tully HM","year":"2014","unstructured":"Tully HM, Dobyns WB. Infantile hydrocephalus: a review of epidemiology, classification and causes. Eur J Med Genet. 2014;57(8):359\u2013368. doi:10.1016\/j.ejmg.2014.06.002"},{"issue":"5","key":"b4","series-title":"Pediatr Neurosurg","first-page":"230","article-title":"Long-term follow-up data from the shunt design trial","volume":"33","author":"Kestle J","year":"2000","unstructured":"Kestle J, Drake J, Milner R,  Long-term follow-up data from the shunt design trial. Pediatr Neurosurg. 2000;33(5):230\u2013236. doi:10.1159\/000055960"},{"issue":"6","key":"b5","series-title":"Pediatr Neurosurg","first-page":"381","article-title":"Cerebrospinal fluid shunting complications in children","volume":"52","author":"Hanak BW","year":"2017","unstructured":"Hanak BW, Bonow RH, Harris CA, Browd SR. Cerebrospinal fluid shunting complications in children. Pediatr Neurosurg. 2017;52(6):381\u2013400. doi:10.1159\/000452840"},{"issue":"2","key":"b6","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. doi:10.1016\/j.pediatrneurol.2005.05.020"},{"issue":"6","key":"b7","series-title":"J Neurosurg Pediatr","first-page":"554","article-title":"Racial disparities in hydrocephalus mortality and shunt revision: a study from the Hydrocephalus Clinical Research Network","volume":"35","author":"Rocque BG","year":"2025","unstructured":"Rocque BG, Jensen H, Reeder RW,  Racial disparities in hydrocephalus mortality and shunt revision: a study from the Hydrocephalus Clinical Research Network. 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Am J Public Health. 2002;92(7):1100\u20131102. doi:10.2105\/ajph.92.7.1100"},{"issue":"4","key":"b21","series-title":"J Expo Sci Environ Epidemiol","first-page":"718","article-title":"Identification of high lead exposure locations in Ohio at the census tract scale using a generalizable geospatial hotspot approach","volume":"34","author":"Stanek LW","year":"2024","unstructured":"Stanek LW, Xue J, Zartarian VG,  Identification of high lead exposure locations in Ohio at the census tract scale using a generalizable geospatial hotspot approach. 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J Hum Resour. 2015;50:317\u2013372."},{"issue":"4","key":"b26","series-title":"Ann Intern Med","first-page":"268","article-title":"Sensitivity analysis in observational research: introducing the E-value","volume":"167","author":"VanderWeele TJ","year":"2017","unstructured":"VanderWeele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med. 2017;167(4):268\u2013274. doi:10.7326\/M16-2607"},{"key":"b27","series-title":"R: A Language and Environment for Statistical Computing","unstructured":"R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. 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