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Evaluation of Long-term Outcomes and Prediction of Failure Rate of Endoscopic Third Ventriculostomy in Less Than 2 Years Children

Hasanreza Mohammadi, Masoud Sadat, Hamidreza Khayat Kashani
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Abstract

Background: The study was carried out to assess long term outcomes of ETV on less than 2 years hydrocephalous children and to determine prognostic factors of ETV success in this population.

Methods: our study was a retrospective cohort study which was carried out on 40 hydrocephalus children who were underwent ETV surgery. Clinical data were retrieved from patient’s medical records and we did active follow-up.  We used Kaplan-Meier and life-Table approaches to assess 6 months success rate of ETV. We also used multiple cox regression to determine prognostic factors associated to success. Moreover, ROC curve analysis was used to assess how ETVSS can predict possibility of ETV failure.

Results: Mean age of patients at surgery time was 7.8 (±7.8) months and 60% were male. Mean of failure time of ETV was 4.5 months and the most prevalent etiology was aqueduct (27.0%). According to our finding age at surgery time (HR=2.2, 95% CI= 1.1, 3.4) and birth age (HR=4.4, 95% CI 1.1, 17.2) were the main factors associated to ETV failure. We also observed, statistically lower hazard ratio for patients with aqueduct etiology (HR= 0.1, 95% CI= 0.01, 0.9). Moreover, area under ROC curve was estimated 76.1 illustrating partial validity to predict ETV failure in the study population.

Conclusion: According to our findings ETV could be suggested to treat Hydrocephaly in young kids with particular attention on over 6 month patients and those ones who were mature at birth. However, more studies are required to confirm our findings.   


Keywords

Obstructive hydrocephalus; Aqueduct Stenosis; Endoscopic Third Ventriculostomy; Infant; Pediatric neurosurgery

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