J Neurol Surg A Cent Eur Neurosurg 2015; 76 - A083
DOI: 10.1055/s-0035-1566402

Perioperative Comorbidities in the Treatment of Hydrocephalus

M. Samardžić 1, M. Mihajlović 2, M. Mrdak 2, A. Janićijević 3, N. Repac 3, I. Nikolić 3, 4, L. Rasulić 3, 4, G. Tasić 3, 4
  • 1Department of Neurosurgery, Clinical Center Zemun, Beograd, Serbia
  • 2University Pediatric Hospital, Belgrade, Serbia
  • 3Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
  • 4Medical Faculty, University of Belgrade, Belgrade, Serbia

Introduction The objective of this study was to demonstrate the predictive value and the presence of diagnostic comorbidity and perioperative factors in the outcome of shunt surgery for hydrocephalus.

Material and Methods We retrospectively analyzed a series of 32 patients who underwent surgery for NTH on Neurosurgical Service KBC Zemun in the 2006–2012 period. Diagnostic factors were analyzed: clinical signs (gait disturbance, cognitive deficits, and incontinence), Evans' index, and lumbar puncture. Perioperative comorbidity factors analyzed were arterial hypertension, diabetes mellitus, and cerebrovascular insult.

Results Of the total of 32 operated patients, –– had gait disturbance, 24 had cognitive deficits, and 23 had urinary incontinence. Twenty patients had improving gait disturbance, 13 had cognitive deficits, and 11 had urinary incontinence. Improvement of gait disturbance was significantly different (p < 0.05) than the other two improved clinical signs. Of the factors of perioperative comorbidities, hypertension was the most common (24), with diabetes mellitus showing a statistically significant predictor of unfavorable outcome (p = 0.029).

Conclusion Gait disturbance proved to be the most common diagnostic NTH factor and the factor that has the best prognosis in patients operated for NTH, while DM is the most common factor of perioperative comorbidities.

Keywords hydrocephalus; comorbidities