A mathematical model of survival in a newly inserted ventricular shunt.

Abstract

The object of this study was to mathematically model the prognosis of a newly inserted shunt in pediatric or adult patients with hydrocephalus. A structured search was performed of the English-language literature for case series reporting shunt failure, patient mortality, and shunt removal rates after shunt insertion. A metaanalytic model was constructed to pool data from multiple studies and to predict the outcome of a shunt after insertion. Separate models were used to predict shunt survival rates for children (patients < 17 years old) and adults. Shunt survival rates in children and adults were calculated for 1 year (64.2 and 80.1%, respectively), 5 years (49.4 and 60.2%, respectively), and the median (4.9 and 7.3 years, respectively). The longer-term rates predicted by the model agree closely with those reported in the literature. This model gives a comprehensive view of the fate of a shunt for hydrocephalus after insertion. The advantages of this model compared with Kaplan-Meier survival curves are discussed. The model used in this study may provide useful prognostic information and aid in the early evaluation of new shunt designs and techniques.