Survival outcomes and risk factors for ventriculo-peritoneal shunt failure in pediatric hydrocephalus: a multi-center cohort study in Vietnam.
| Title: | Survival outcomes and risk factors for ventriculo-peritoneal shunt failure in pediatric hydrocephalus: a multi-center cohort study in Vietnam. |
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| Authors: | Can DDT; School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Cho Lon Ward, Ho Chi Minh City, Vietnam. drthanhcan@ump.edu.vn.; Department of Neurosurgery, City Children's Hospital, Ho Chi Minh City, Vietnam. drthanhcan@ump.edu.vn.; Giang NDH; School of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Cho Lon Ward, Ho Chi Minh City, Vietnam.; Department of Neurosurgery, Children's Hospital 2, Ho Chi Minh City, Vietnam.; Khai ND; Department of Neurosurgery, City Children's Hospital, Ho Chi Minh City, Vietnam.; Hanh NTK; Department of Neurosurgery, City Children's Hospital, Ho Chi Minh City, Vietnam.; Tri PM; Department of Neurosurgery, Children's Hospital 1, Ho Chi Minh City, Vietnam.; Tien NTT; Department of Neurosurgery, Children's Hospital 1, Ho Chi Minh City, Vietnam.; Chau PT; Department of Neurosurgery, Da Nang Hospital for Women and Children, Da Nang, Vietnam.; Binh PH; Department of Neurosurgery, Da Nang Hospital for Women and Children, Da Nang, Vietnam. |
| Source: | Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2026 Feb 16; Vol. 42 (1), pp. 74. Date of Electronic Publication: 2026 Feb 16. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Springer International Country of Publication: Germany NLM ID: 8503227 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-0350 (Electronic) Linking ISSN: 02567040 NLM ISO Abbreviation: Childs Nerv Syst Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin : Springer International, c1985- |
| MeSH Terms: | Ventriculoperitoneal Shunt*/adverse effects ; Ventriculoperitoneal Shunt*/mortality ; Hydrocephalus*/surgery ; Hydrocephalus*/mortality ; Hydrocephalus*/etiology; Vietnam/epidemiology ; Humans ; Male ; Female ; Child ; Risk Factors ; Child, Preschool ; Retrospective Studies ; Infant ; Adolescent ; Cohort Studies ; Treatment Outcome ; Infant, Newborn |
| Abstract: | Purpose: This study aims to assess the survival outcomes of ventriculo-peritoneal shunt (VPS) and identify risk factors for shunt failure when using the standardized protocol in Vietnamese children.; Methods: This was a multi-center retrospective cohort study at four pediatric centers in Vietnam. All patients less than 16 years old who underwent initial VPS placement between 2021 and 2024 were included. The Kaplan-Meier method was employed for survival analysis. Risk factors were identified using Cox regression models.; Results: A total of 334 individuals were enrolled with a median follow-up (FU) of 21 months. Brain tumors (59.6%), post-meningitis (14.7%), and congenital abnormalities (14.3%) were the most common etiologies of hydrocephalus. Shunt infection rate was 14.1%. Low rate of full compliance with protocol (39.5%) increased shunt infection (p = 0.01). The 1-, 2-, and 3-year overall survival (OS) of VPS was 69%, 64%, and 61%, respectively, with an estimated mean survival time (ST) of 26 months. Post-meningitis hydrocephalus, non-compliance with shunt protocol, and improper technique were independent risk factors for shunt failure with adjusted hazard ratios (95% confidence interval) (aHR [CI]) of 1.82 (1.09-3.03), 1.69 (1.08-2.64), and 5.57 (2.90-10.69), respectively.; Conclusions: The shunt survival outcomes in Vietnamese children remain consistent with those in other populations in similar settings. Post-meningitis hydrocephalus, non-compliance, and improper technique are independently associated with reduced shunt survival. Recommendations include standardizing surgical techniques and ensuring full compliance with shunt protocol to prevent infection and improve shunt outcomes. This study also underscores the feasibility and efficiency of implementing the standardized shunt protocol in resource-limited countries.; (© 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
| Competing Interests: | Declarations. Ethics approval: This study was approved by the local Institutional Review Boards at participating centers and University of Medicine and Pharmacy at Ho Chi Minh City (ethics approval ID: 17/23-BVND2) in accordance with the Helsinki Declaration. Consent to participate: The informed consent of the participants was obtained from the parents or legal guardians. Competing interests: The authors declare no competing interests. Previous presentation: Portions of this study were presented at the 51 st Annual Meeting of the International Society for Pediatric Neurosurgery, Lyon, France, October 2025 for the ISPN A.J. Raimondi Award 2025. |
| Comments: | Erratum in: Childs Nerv Syst. 2026 Mar 23;42(1):128. doi: 10.1007/s00381-026-07220-0.. (PMID: 41870656) |
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| Contributed Indexing: | Keywords: Pediatric hydrocephalus; Shunt survival; Ventriculo-peritoneal shunt |
| Entry Date(s): | Date Created: 20260216 Date Completed: 20260217 Latest Revision: 20260323 |
| Update Code: | 20260323 |
| DOI: | 10.1007/s00381-026-07178-z |
| PMID: | 41699343 |
| Database: | MEDLINE |
Journal Article; Multicenter Study