Factors associated with postoperative complications in hydrocephalic infants diagnosed at Bernard Mevs Hospital in Port-au-Prince, Haiti from 2011 to 2013.

Factors associated with postoperative complications in hydrocephalic infants diagnosed at Bernard Mevs Hospital in Port-au-Prince, Haiti from 2011 to 2013.

World Neurosurg. 2017 Apr 19;:

Authors: Joseph FJ, Bernard J, Augustin S

Abstract
OBJECTIVE: Complications worsen the prognosis of hydrocephalic children who undergo surgery. The main objective of this study was to determine factors associated with postoperative complications in Haitian hydrocephalic infants.
METHODS: This is a cross-sectional study conducted on hydrocephalic infants diagnosed in a Haitian hospital from 2011 to 2013. Records were consulted to gather key variables that were evaluated in relation to the occurrence of postoperative complications. Any variable whose p value was less than 0.05 for the Mantel-Haenszel chi-square test was considered a factor associated with postoperative complications.
RESULTS: The prevalence of hydrocephalus in our sample was 6.6%. Of the 131 cases of hydrocephalus surveyed, 75 were selected. The sex ratio was 1.02 and the age group from 1 to 6 months old was the most affected (52% of cases). The increase in head circumference (96% of cases) was the most common clinical sign. Seventy point seven per cent of the infants underwent imaging work-up and 26.7% had central nervous system malformations. Eighty-four per cent received surgical treatment and a third of the operated infants presented complications, the most common being infection (8%). Postoperative mortality was 6.7%, and 40% of operated infants had no postoperative care after medical discharge. Ventriculoperitoneal shunt was more significantly associated with complications than endoscopic third ventriculostomy (Odds Ratio = 3.25, p = 0.03).
CONCLUSIONS: Hydrocephalus in Haitian infants is diagnosed late, inadequately investigated, treated, and monitored. Ventriculoperitoneal shunts are significantly related to more postoperative complications than endoscopic third ventriculostomy.

PMID: 28433846 [PubMed - as supplied by publisher]

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