Please note that this age is the average age of the patients reported in the article, as the actual age of patients involved was not provided.Please note that this is the gender of the majority of patients reported in the article as the actual genders of patients involved was not provided.If information is provided in the future, a supplemental report will be issued.
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Eduardo orrego-gonzález, alejandro enriquez-marulanda, luis c.Ascanio, noah jordan, khalid a.Hanafy, justin m.Moore, christopher s.Ogilvy, ajith j.Thomas.A cohort comparison analysis of fixed pressure ventriculoperitoneal shunt valveswith programmable valves for hydrocephalus following nontraumatic subarachnoid hemorrhage.Operative neurosurgery 0 (2019).Doi: 10.1093/ons/opz195 background: hydrocephalus after nontraumatic subarachnoid hemorrhage (sah) is a common sequela that may require the placement of ven triculoperitoneal shunts (vps).Adjustable-pressure valves (apvs) are being widely used in this situation though more expensive than differential-pressure valves (dpvs).Objective: to compare outcomes between apv and dpv in sah-induced hydrocephalus.Methods: we performed a retrospective chart review of patients with nontraumatic sah who underwent vps placement for the treatment of hydrocephalus after sah, between july 2007 and december 2016.Patients were classified according to the type of valve (apv vs dpv).We evaluated factors that could predict the type of valve used, outcomes in vps revision/replacement rate, and complications.Results: a total of 66 patients underwent vps placement who were equally distributed into the 2 groups of valves.Vps failure with the need for revision/replacement occurred in 13 (19.7%) cases.Ten (30.3%) patients with dpv had a vps failure, while 3 (9.1%) patients with an apv had a similar failure with the need for revision/replacement (p =.03).Vps placement before discharge during the initial hospitalization(p =.02) was statistically significant associated with the use of a dpv, while the reason of external ventricular drain (evd) failure (p =.03) was associated with the use of an apv.Conclusion: apvs had a lower rate of surgical revisions compared to dpvs.Early placement of vps was associated with the use of a dpv.The need for evd replacement due to evd infection or malfunction was ass ociated with higher rates of apv use.Reported events.- 1 patient in the apv group had a complication due to underdrainage.The patient presentation was enlarged ventricles, and they were treated with a pressure level adjustment in which it was changed from 1.0 to 0.5 - 2 patients in the apv group experienced hygromas due to overdrainage.The patients were treated with a pressure level adjustment in which they were changed from 1.5 to 2.0.
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