In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Etiologies of Early Ventricular Shunt Malfunctions and Proposal of a New Quality Metric

    Final Number:
    192

    Authors:
    Paul Klimo MD, MPH; Garrett T. Venable BS; Nicholas Rossi MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Complications from ventriculoperitoneal shunting are well-known and costly. Revision rates at certain time periods (ex. 30, 60 and 180-days) have been proposed as quality metrics. The purpose of this study was to perform a detailed analysis of shunt failure etiology in an effort to produce a more appropriate quality metric.

    Methods: Le Bonhuer Children’s Hospital records were reviewed to identify all patients admitted for shunt related procedures (01/2010-06/2014). Shunt malfunctions within 90-days of index procedure were reviewed thoroughly to identify the root cause of shunt malfunction. Extracted data for each index and revision procedure included demographic, clinical and operative.

    Results: We identified 188 failures within 90-days of the index shunt operation, the majority of them occurring within 30 days (70.2%). The most common types of failure included surgical site infection (14.9%), proximal catheter (43.6%), valve malfunction(12.2%), distal catheter (15.4%), and some combination (6.3%). Potentially preventable shunt failures, which included malpositioned proximal and distal catheters and infection, comprised 29.8% of the 90-day failures.

    Conclusions: An overall shunt revision rate at any time period is not an appropriate quality metric. However, we have identified a new metric – the preventable shunt revision rate (PSRR) – at 90 days as a metric that is meaningful, measureable and modifiable. It is the one that all institutions should track and institute processes to minimize.

    Patient Care: The Preventable Shunt Revision Rate can be used to track early shunt malfunctions and institute a strategy to lower it, which will translate into lower overall shunt malfunction rates.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of preventing shunt malfunction, 2) Discuss, in small groups, the key attributes of a quality metric, 3) Identify an effective strategy to prevent early shunt malfunction.

    References:

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy