Evaluation der Shunttherapie von Kindern mit Hydrozephalus durch Implementierung eines digitalen Shuntregisters

Evaluation of shunt therapy in children with hydrocephalus by implementing a digital shunt register

by Maximilian Kanzler
Doctoral thesis
Date of Examination:2021-05-27
Date of issue:2021-05-12
Advisor:Prof. Dr. Hans-Christoph Ludwig
Referee:Prof. Dr. Hans-Christoph Ludwig
Referee:PD Dr. Steffi Dreha-Kulaczewski
Referee:Prof. Dr. mult. Thomas Meyer
Persistent Address: http://dx.doi.org/10.53846/goediss-8588

 

 

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Abstract

English

Treatment monitoring and outcome evaluation of shunt therapy in pediatric hydrocephalus require gapless, detailed documentation regarding surgical and clinical follow-up data beginning from day one of treatment until adulthood. A digital tool to capture, organize, and analyze comprehensive treatment-related data was overdue. Consequentially it was developed and implemented in daily pediatric neurosurgical routine. The pediatric hydrocephalus register application delivers easy access to contemporary and up-to-date clinical information during daily clinical routine and proves comprehensive value for various scientific purposes. For the first time, the institutional hydrocephalus aetiologies, treatment algorithms, valve types and the surgical outcome for a period of time of more than 20 years could be reviewed in a manner appropriate to the complexity of the disease. The surgical outcome of the institution did not differ significantly from the results of international literature. Preterm birth, a low gestational age (<28 weeks) and a low age at the time of the initial shunt implantation (<12 months) were identified as risk factors for early postoperative complications. On the aetiological side, posthemorrhagic hydrocephalus in premature infants could be identified as particularly unfavorable and consequently as an urgent research area. The digital register emerged to an sustainable tool to capture, organize, and analyze patterns of care in pediatric hydrocephalus patients of the institution. Because of its adaptable and reliable predicate, a prospective multi-center utilization is aspired.
Keywords: hydrocephalus
Schlagwörter: Hydrozephalus
 
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