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. 2022 Oct;38(10):1885-1894.
doi: 10.1007/s00381-022-05590-9. Epub 2022 Jul 6.

Long-term quality of life after ETV or ETV with consecutive VP shunt placement in hydrocephalic pediatric patients

Victoria Bogaczyk  1 , Steffen Fleck  2 , Julia Berneiser  3 , Michael Opolka  3 , Marcus Vollmer  4 , Jörg Baldauf  2 , Christin Maria Gasch  2 , Eva Maria Lemke  2 , Ehab El Refaee  2 , Marc Matthes  2 , Holger Hirschfeld  5 , Heinz Lauffer  6 , Michael Gaab  7 , Henry Schroeder  2 , Sascha Marx  2
Affiliations

Long-term quality of life after ETV or ETV with consecutive VP shunt placement in hydrocephalic pediatric patients

Victoria Bogaczyk et al. Childs Nerv Syst. 2022 Oct.

Erratum in

Abstract

Purpose: Endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunting are well-established treatments of obstructive hydrocephalus (HCP) in adult and pediatric patients. However, there is a lack of data with regard to the quality of life (QoL) of these patients during long-term follow-up METHODS: Inclusion criteria were pediatric patients with endoscopic treatment of hydrocephalus at the University Medicine Greifswald between 1993 and 2016. Patients older than 14 years at present were assessed with the Short Form-12 (SF-12) questionnaire. Patients younger than 14 years of age were assessed with the KINDL-R questionnaire that was completed by their parents. Patients' values were compared with the scores of a corresponding age-matched group of the healthy population and with patients who received later shunt treatment. Information about comorbidities, current symptoms, and educational level were gained by an additional part. Comparative analysis between patients with ETV success and failure (defined as shunt implantation after ETV) was performed.

Results: A total of 107 patients (53 m, 54f) were included. Fifty-seven/107 patients (53.3%) were considered as ETV success. Mean age at ETV was 6.9 ± 5.9 years. Fifty-four statements of 89 patients that are still alive were gained (response rate 63%). Of these, 49 questionnaires were complete and evaluable (23 m, 26f; mean age 19.8 ± 10.0 years with an average follow-up period of 13.7 ± 7.2 years). Twenty-six/49 patients (53.1%) are considered ETV success. No statistically significant differences could be obtained between patients with ETV success and ETV failure. Patients older 14 years show QoL within normal range, patients younger than 14 years show significantly lower result regarding their environment of peers and social contacts. Patients younger than 6 months at the time of ETV and patients with posthemorrhagic HCP show significantly lower physical QoL. Gait disturbance, fatigue, and seizures are associated with a lower QoL, and educational level is lower than in the normal population.

Conclusions: Patients who underwent ETV in childhood do not have a lower health-related QoL in general. Subsequent insertions of ventriculoperitoneal (vp) shunts do not lower QoL. Certain subgroups of the patients show lower results compared to the healthy population.

Keywords: Endoscopic third ventriculostomy; Hydrocephalus; Pediatric; Quality of life.

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Conflict of interest statement

Henry W. S. Schroeder is a consultant for Karl Storz SA & Co. KG, Tuttlingen, Germany. All other authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart about the response and the scheme of evaluation of patients treated with ETV during 1993–2016. SF-12, Short-Form Health Survey 12
Fig. 2
Fig. 2
Average health dimensions evaluated with KINDL-R questionnaire in children. QoL, quality of life
Fig. 3
Fig. 3
Comparisons between PCS and MCS of patients with ETV success and failure, total study group, and reference group. ETV, endoscopic third ventriculostomy; PCS, physical component summary; MCS, mental component summary
Fig. 4
Fig. 4
Clinical symptoms and their impact on physical QoL. ETV, endoscopic third ventriculostomy; PCS, physical component summary
Fig. 5
Fig. 5
Physical component summary for subgroups compared with the total study group and reference group. PCS, physical component summary
Fig. 6
Fig. 6
Educational degrees of the study group
See this image and copyright information in PMC

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