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Multicenter Study
. 2009 Aug;155(2):254-9.e1.
doi: 10.1016/j.jpeds.2009.02.048. Epub 2009 May 15.

Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus

Abhaya V Kulkarni  1 , James M Drake, Conor L Mallucci, Spyros Sgouros, Jonathan Roth, Shlomi Constantini; Canadian Pediatric Neurosurgery Study Group
Collaborators, Affiliations
Multicenter Study

Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus

Abhaya V Kulkarni et al. J Pediatr. 2009 Aug.

Abstract

Objective: To develop a model to predict the probability of endoscopic third ventriculostomy (ETV) success in the treatment for hydrocephalus on the basis of a child's individual characteristics.

Study design: We analyzed 618 ETVs performed consecutively on children at 12 international institutions to identify predictors of ETV success at 6 months. A multivariable logistic regression model was developed on 70% of the dataset (training set) and validated on 30% of the dataset (validation set).

Results: In the training set, 305/455 ETVs (67.0%) were successful. The regression model (containing patient age, cause of hydrocephalus, and previous cerebrospinal fluid shunt) demonstrated good fit (Hosmer-Lemeshow, P = .78) and discrimination (C statistic = 0.70). In the validation set, 105/163 ETVs (64.4%) were successful and the model maintained good fit (Hosmer-Lemeshow, P = .45), discrimination (C statistic = 0.68), and calibration (calibration slope = 0.88). A simplified ETV Success Score was devised that closely approximates the predicted probability of ETV success.

Conclusions: Children most likely to succeed with ETV can now be accurately identified and spared the long-term complications of CSF shunting.

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