Factors Associated with Postoperative Complications in Hydrocephalic Infants Diagnosed at Bernard Mevs Hospital in Port-au-Prince, Haiti, from 2011 to 2013.

Abstract

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 infants with hydrocephaly. This was 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 χ² test was considered a factor associated with postoperative complications. 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. A total of 70.7% of the infants underwent imaging work-up, and 26.7% had central nervous system malformations. A total of 84% received surgical treatment, and one third of the operated infants presented with 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). Hydrocephalus in Haitian infants is diagnosed late and inadequately investigated, treated, and monitored. Ventriculoperitoneal shunts are significantly related to more postoperative complications than endoscopic third ventriculostomy.