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Evaluation of the ETV success score and its predictive value in pediatric occlusive hydrocephalus: implications for patient counseling

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Název: Evaluation of the ETV success score and its predictive value in pediatric occlusive hydrocephalus: implications for patient counseling
Autoři: Krause, Matthias, Gräfe, Daniel, Metzger, Roman, Griessenauer, Christoph J., Gburek-Augustat, Janina
Zdroj: Childs Nerv Syst
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Counseling, Adolescent, Research, Infant, Newborn, Infant, Ventriculostomy, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Predictive Value of Tests, Child, Preschool, Neuroendoscopy, Humans, Female, Child, Hydrocephalus/diagnostic imaging [MeSH], Infant, Newborn [MeSH], Adolescent [MeSH], Female [MeSH], ETV Success Score, Humans [MeSH], Treatment Outcome [MeSH], Aqueductal stenosis, Predictive Value of Tests [MeSH], Retrospective Studies [MeSH], Counseling/methods [MeSH], Neuroendoscopy/methods [MeSH], Endoscopic Third Ventriculostomy, Infant [MeSH], Male [MeSH], Ventriculostomy/methods [MeSH], Pediatric hydrocephalus, Ventriculoperitoneal shunt, Third Ventricle/diagnostic imaging [MeSH], Child [MeSH], Hydrocephalus/surgery [MeSH], Third Ventricle/surgery [MeSH], Child, Preschool [MeSH], Hydrocephalus, Third Ventricle, Retrospective Studies
Popis: Introduction Endoscopic Third Ventriculostomy (ETV) is a well-established treatment for pediatric hydrocephalus, particularly in cases of aqueductal stenosis. The ETV Success Score (ETVSS) is a predictive tool widely used to estimate the likelihood of ETV success based on factors like age. Its accuracy, especially in infants under 3 months, is still debated. Patients and methods This study evaluates the age-dependency of ETV success in 54 pediatric patients compared to ETVSS predictions. Patients were divided into age and pathology groups according to Kulkarni. Success was defined according the ETVSS criteria. Minimum follow-up was 12 months and included MRI to demonstrate a flow void at the floor or the third ventricle. Results Our institutional data revealed a higher overall success rate SR (88%) compared to the ETVSS-predicted rate of 73%. Despite small numbers within subgroups, especially in very young children Discussion Our results show significantly higher actual SR across all age groups compared to ETVSS predictions (p = 0.035) when selected and performed by an experienced physician. The age groups > 1 year had significantly higher SR close to 100% (p p = 0.0038, respectively). This suggests that ETV may be underutilized, particularly in infants, where predicted success rates are pessimistic. Conclusion ETVSS is a useful tool for counseling of parents, but differences in institution-specific outcomes should not be neglected. Depending on that, physicians might opt in favor of ETV as primary treatment in occlusive hydrocephalus of very young children, counterbalancing risks and sequalae of VP-shunting.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1433-0350
0256-7040
DOI: 10.1007/s00381-024-06728-7
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39731585
https://repository.publisso.de/resource/frl:6507003
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....2e7eb2ed16dd9998d5f28af085fa0b3b
Databáze: OpenAIRE
Popis
Abstrakt:Introduction Endoscopic Third Ventriculostomy (ETV) is a well-established treatment for pediatric hydrocephalus, particularly in cases of aqueductal stenosis. The ETV Success Score (ETVSS) is a predictive tool widely used to estimate the likelihood of ETV success based on factors like age. Its accuracy, especially in infants under 3 months, is still debated. Patients and methods This study evaluates the age-dependency of ETV success in 54 pediatric patients compared to ETVSS predictions. Patients were divided into age and pathology groups according to Kulkarni. Success was defined according the ETVSS criteria. Minimum follow-up was 12 months and included MRI to demonstrate a flow void at the floor or the third ventricle. Results Our institutional data revealed a higher overall success rate SR (88%) compared to the ETVSS-predicted rate of 73%. Despite small numbers within subgroups, especially in very young children Discussion Our results show significantly higher actual SR across all age groups compared to ETVSS predictions (p = 0.035) when selected and performed by an experienced physician. The age groups > 1 year had significantly higher SR close to 100% (p p = 0.0038, respectively). This suggests that ETV may be underutilized, particularly in infants, where predicted success rates are pessimistic. Conclusion ETVSS is a useful tool for counseling of parents, but differences in institution-specific outcomes should not be neglected. Depending on that, physicians might opt in favor of ETV as primary treatment in occlusive hydrocephalus of very young children, counterbalancing risks and sequalae of VP-shunting.
ISSN:14330350
02567040
DOI:10.1007/s00381-024-06728-7