Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry

Irene Kim, Betsy Hopson, Inmaculada Aban, Elias Rizk, Mark Dias, Robin Bowman, Laurie L. Ackerman, Michael D. Partington, Heidi Castillo, Jonathan Castillo, Paula R. Peterson, Jeffrey P. Blount, Brandon G. Rocque

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: Although the majority of patients with myelomeningocele have hydrocephalus, reported rates of hydrocephalus treatment vary widely. The purpose of this study was to determine the rate of surgical treatment for hydrocephalus in patients with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in shunting rates across NSBPR institutions, examined the relationship between hydrocephalus, and the functional lesion level of the myelomeningocele, and evaluated for temporal trends in rates of treated hydrocephalus. Methods: The authors queried the NSBPR to identify all patients with myelomeningoceles. Individuals were identified as having been treated for hydrocephalus if they had undergone at least 1 hydrocephalus-related operation. For each participating NSBPR institution, the authors calculated the proportion of patients with treated hydrocephalus who were enrolled at that site. Logistic regression was performed to analyze the relationship between hydrocephalus and the functional lesion level of the myelomeningocele and to compare the rate of treated hydrocephalus in children born before 2005 with those born in 2005 or later. Results: A total of 4448 patients with myelomeningocele were identified from 26 institutions, of whom 3558 patients (79.99%) had undergone at least 1 hydrocephalus-related operation. The rate of treated hydrocephalus ranged from 72% to 96% among institutions enrolling more than 10 patients. This difference in treatment rates between centers was statistically significant (p < 0.001). Insufficient data were available in the NSBPR to analyze reasons for the different rates of hydrocephalus treatment between sites. Multivariate logistic regression demonstrated that more rostral functional lesion levels were associated with higher rates of treated hydrocephalus (p < 0.001) but demonstrated no significant difference in hydrocephalus treatment rates between children born before versus after 2005. Conclusions: The rate of hydrocephalus treatment in patients with myelomeningocele in the NSBPR is 79.99%, which is consistent with the rates in previously published literature. The authors' data demonstrate a clear association between functional lesion level of the myelomeningocele and the need for hydrocephalus treatment.

Original languageEnglish (US)
Pages (from-to)646-651
Number of pages6
JournalJournal of Neurosurgery: Pediatrics
Volume22
Issue number6
DOIs
StatePublished - Dec 1 2018

Fingerprint

Meningomyelocele
Spinal Dysraphism
Hydrocephalus
Registries
Therapeutics
Logistic Models

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Kim, Irene ; Hopson, Betsy ; Aban, Inmaculada ; Rizk, Elias ; Dias, Mark ; Bowman, Robin ; Ackerman, Laurie L. ; Partington, Michael D. ; Castillo, Heidi ; Castillo, Jonathan ; Peterson, Paula R. ; Blount, Jeffrey P. ; Rocque, Brandon G. / Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry. In: Journal of Neurosurgery: Pediatrics. 2018 ; Vol. 22, No. 6. pp. 646-651.
@article{689c2ab679384d9e9fe7a745a1f04351,
title = "Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry",
abstract = "Objective: Although the majority of patients with myelomeningocele have hydrocephalus, reported rates of hydrocephalus treatment vary widely. The purpose of this study was to determine the rate of surgical treatment for hydrocephalus in patients with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in shunting rates across NSBPR institutions, examined the relationship between hydrocephalus, and the functional lesion level of the myelomeningocele, and evaluated for temporal trends in rates of treated hydrocephalus. Methods: The authors queried the NSBPR to identify all patients with myelomeningoceles. Individuals were identified as having been treated for hydrocephalus if they had undergone at least 1 hydrocephalus-related operation. For each participating NSBPR institution, the authors calculated the proportion of patients with treated hydrocephalus who were enrolled at that site. Logistic regression was performed to analyze the relationship between hydrocephalus and the functional lesion level of the myelomeningocele and to compare the rate of treated hydrocephalus in children born before 2005 with those born in 2005 or later. Results: A total of 4448 patients with myelomeningocele were identified from 26 institutions, of whom 3558 patients (79.99{\%}) had undergone at least 1 hydrocephalus-related operation. The rate of treated hydrocephalus ranged from 72{\%} to 96{\%} among institutions enrolling more than 10 patients. This difference in treatment rates between centers was statistically significant (p < 0.001). Insufficient data were available in the NSBPR to analyze reasons for the different rates of hydrocephalus treatment between sites. Multivariate logistic regression demonstrated that more rostral functional lesion levels were associated with higher rates of treated hydrocephalus (p < 0.001) but demonstrated no significant difference in hydrocephalus treatment rates between children born before versus after 2005. Conclusions: The rate of hydrocephalus treatment in patients with myelomeningocele in the NSBPR is 79.99{\%}, which is consistent with the rates in previously published literature. The authors' data demonstrate a clear association between functional lesion level of the myelomeningocele and the need for hydrocephalus treatment.",
author = "Irene Kim and Betsy Hopson and Inmaculada Aban and Elias Rizk and Mark Dias and Robin Bowman and Ackerman, {Laurie L.} and Partington, {Michael D.} and Heidi Castillo and Jonathan Castillo and Peterson, {Paula R.} and Blount, {Jeffrey P.} and Rocque, {Brandon G.}",
year = "2018",
month = "12",
day = "1",
doi = "10.3171/2018.5.PEDS18161",
language = "English (US)",
volume = "22",
pages = "646--651",
journal = "Journal of Neurosurgery: Pediatrics",
issn = "1933-0707",
publisher = "American Association of Neurological Surgeons",
number = "6",

}

Kim, I, Hopson, B, Aban, I, Rizk, E, Dias, M, Bowman, R, Ackerman, LL, Partington, MD, Castillo, H, Castillo, J, Peterson, PR, Blount, JP & Rocque, BG 2018, 'Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry', Journal of Neurosurgery: Pediatrics, vol. 22, no. 6, pp. 646-651. https://doi.org/10.3171/2018.5.PEDS18161

Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry. / Kim, Irene; Hopson, Betsy; Aban, Inmaculada; Rizk, Elias; Dias, Mark; Bowman, Robin; Ackerman, Laurie L.; Partington, Michael D.; Castillo, Heidi; Castillo, Jonathan; Peterson, Paula R.; Blount, Jeffrey P.; Rocque, Brandon G.

In: Journal of Neurosurgery: Pediatrics, Vol. 22, No. 6, 01.12.2018, p. 646-651.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Treated hydrocephalus in individuals with myelomeningocele in the National Spina Bifida Patient Registry

AU - Kim, Irene

AU - Hopson, Betsy

AU - Aban, Inmaculada

AU - Rizk, Elias

AU - Dias, Mark

AU - Bowman, Robin

AU - Ackerman, Laurie L.

AU - Partington, Michael D.

AU - Castillo, Heidi

AU - Castillo, Jonathan

AU - Peterson, Paula R.

AU - Blount, Jeffrey P.

AU - Rocque, Brandon G.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objective: Although the majority of patients with myelomeningocele have hydrocephalus, reported rates of hydrocephalus treatment vary widely. The purpose of this study was to determine the rate of surgical treatment for hydrocephalus in patients with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in shunting rates across NSBPR institutions, examined the relationship between hydrocephalus, and the functional lesion level of the myelomeningocele, and evaluated for temporal trends in rates of treated hydrocephalus. Methods: The authors queried the NSBPR to identify all patients with myelomeningoceles. Individuals were identified as having been treated for hydrocephalus if they had undergone at least 1 hydrocephalus-related operation. For each participating NSBPR institution, the authors calculated the proportion of patients with treated hydrocephalus who were enrolled at that site. Logistic regression was performed to analyze the relationship between hydrocephalus and the functional lesion level of the myelomeningocele and to compare the rate of treated hydrocephalus in children born before 2005 with those born in 2005 or later. Results: A total of 4448 patients with myelomeningocele were identified from 26 institutions, of whom 3558 patients (79.99%) had undergone at least 1 hydrocephalus-related operation. The rate of treated hydrocephalus ranged from 72% to 96% among institutions enrolling more than 10 patients. This difference in treatment rates between centers was statistically significant (p < 0.001). Insufficient data were available in the NSBPR to analyze reasons for the different rates of hydrocephalus treatment between sites. Multivariate logistic regression demonstrated that more rostral functional lesion levels were associated with higher rates of treated hydrocephalus (p < 0.001) but demonstrated no significant difference in hydrocephalus treatment rates between children born before versus after 2005. Conclusions: The rate of hydrocephalus treatment in patients with myelomeningocele in the NSBPR is 79.99%, which is consistent with the rates in previously published literature. The authors' data demonstrate a clear association between functional lesion level of the myelomeningocele and the need for hydrocephalus treatment.

AB - Objective: Although the majority of patients with myelomeningocele have hydrocephalus, reported rates of hydrocephalus treatment vary widely. The purpose of this study was to determine the rate of surgical treatment for hydrocephalus in patients with myelomeningocele in the National Spina Bifida Patient Registry (NSBPR). In addition, the authors explored the variation in shunting rates across NSBPR institutions, examined the relationship between hydrocephalus, and the functional lesion level of the myelomeningocele, and evaluated for temporal trends in rates of treated hydrocephalus. Methods: The authors queried the NSBPR to identify all patients with myelomeningoceles. Individuals were identified as having been treated for hydrocephalus if they had undergone at least 1 hydrocephalus-related operation. For each participating NSBPR institution, the authors calculated the proportion of patients with treated hydrocephalus who were enrolled at that site. Logistic regression was performed to analyze the relationship between hydrocephalus and the functional lesion level of the myelomeningocele and to compare the rate of treated hydrocephalus in children born before 2005 with those born in 2005 or later. Results: A total of 4448 patients with myelomeningocele were identified from 26 institutions, of whom 3558 patients (79.99%) had undergone at least 1 hydrocephalus-related operation. The rate of treated hydrocephalus ranged from 72% to 96% among institutions enrolling more than 10 patients. This difference in treatment rates between centers was statistically significant (p < 0.001). Insufficient data were available in the NSBPR to analyze reasons for the different rates of hydrocephalus treatment between sites. Multivariate logistic regression demonstrated that more rostral functional lesion levels were associated with higher rates of treated hydrocephalus (p < 0.001) but demonstrated no significant difference in hydrocephalus treatment rates between children born before versus after 2005. Conclusions: The rate of hydrocephalus treatment in patients with myelomeningocele in the NSBPR is 79.99%, which is consistent with the rates in previously published literature. The authors' data demonstrate a clear association between functional lesion level of the myelomeningocele and the need for hydrocephalus treatment.

UR - http://www.scopus.com/inward/record.url?scp=85058777949&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058777949&partnerID=8YFLogxK

U2 - 10.3171/2018.5.PEDS18161

DO - 10.3171/2018.5.PEDS18161

M3 - Article

C2 - 30141753

AN - SCOPUS:85058777949

VL - 22

SP - 646

EP - 651

JO - Journal of Neurosurgery: Pediatrics

JF - Journal of Neurosurgery: Pediatrics

SN - 1933-0707

IS - 6

ER -