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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

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Impact of comorbidities and frailty on early shunt failure in geriatric patients with normal pressure hydrocephalus

Einfluss von Komorbiditäten und Frailty auf frühes Shuntversagen bei geriatrischen Patienten mit Normaldruck-Hydrozephalus

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  • presenting/speaker Fatma Kilinc - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Alexis Hadjiathanasiou - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Bedjan Behmanesh - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Erdem Güresir - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Muriel Heimann - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Jürgen Konczalla - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Elisa Scharnböck - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Matthias Schneider - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Leonie Weinhold - Universitätsklinikum Bonn, Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
  • Hartmut Vatter - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Patrick Schuss - Universitätsklinikum Bonn, Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Florian Gessler - Universitätsklinikum Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV051

doi: 10.3205/21dgnc053, urn:nbn:de:0183-21dgnc0532

Published: June 4, 2021

© 2021 Kilinc et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Older patients are considered to bear a higher perioperative risk. Since idiopathic normal pressure hydrocephalus (NPH) predominantly concerns older patients, identifying risk factors for early shunt failure for preoperative risk/benefit assessment is indispensable for indication and/or consultation of patients for ventriculoperitoneal shunting (VPS).

Methods: We performed a retrospective study design, including data acquired from two university hospital neurosurgical institutions between 2012 and 2019. Overall, 211 consecutive patients with clinical/radiological signs for NPH who additionally showed alleviation of symptoms after lumbar cerebrospinal fluid (CSF) drainage, received VPS and were included for further analysis. Frailty was measured using the Clinical Frailty Scale (CFS). Main outcome was early shunt failure or postoperative complications within 30 days after initial VPS surgery.

Results: The overall complication rate was 14%. Patient-related complications 35 were observed in 13 patients (6%) and procedure-related complications in 16 patients (8%). Early postoperative complications resulted in a significantly prolonged length of hospital stay 6.9 ± 6.8 vs. 10.8±11.8 days (p=0.03). Diabetes mellitus with end-organ damage (OR 35.4, 95% CI 6.6-189.4, p<0.0001) as well as preexisting Parkinson’s disease were associated with early patient-related postsurgical complications after VPS for NPH.

Conclusion: Patients comorbidities but not frailty were associated with early postoperative patient related complications in patients suffering NPH. While frailty may deter patients from other (neurosurgical) procedures, VPS surgery might contribute to treating NPH in these patients at a tolerable risk.