The association between ventriculo-peritoneal shunt and acute appendicitis in traumatic brain injury patients: a 14-year population-based study.

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The association between ventriculo-peritoneal shunt and acute appendicitis in traumatic brain injury patients: a 14-year population-based study.

World Neurosurg. 2017 Apr 01;:

Authors: Lim SW, Ao KH, Ho CH, Tseng CJ, Wang JJ, Chio CC, Kuo JR

Abstract
OBJECTIVE: The association between preexisting ventriculo-peritoneal (VP) shunt and the risk of new-onset acute appendicitis in patients with traumatic brain injury (TBI) is not well established.The aim of the present study was to determine the relationships between VP shunt and acute appendicitis in TBI patients METHODS: A longitudinal cohort study matched by a propensity score in TBI patients with (4781 patients) or without (9562 patients) VP-shunt was conducted using the National Health Insurance Research Database in Taiwan between January 1993 and December 2013.
RESULTS: The main outcome studied was diagnosis of acute appendicitis. The cumulative probability of acute appendicitis was not different between these two groups (p=0.6244). A Cox model showed CNS infection to be an independent predictor of acute appendicitis with adjust Hazard ratio (HR) 2.98. TBI patients with both a VP shunt and a CNS infection had a higher risk of developing new-onset acute appendicitis (HR = 4.25; 95% CI, 1.84-9.81) compared to TBI patients without a VP shunt or CNS infection.
CONCLUSIONS: We concluded that VP shunt is not a risk factor in the development of appendicitis in patients with TBI. TBI patients with a shunt and a CNS infection may have a higher risk of developing acute appendicitis. Therefore, care in avoiding CNS infection is a key for the prevention acute appendicitis in this patient population.

PMID: 28377254 [PubMed - as supplied by publisher]

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