Factors Causing Shunt Malfunction in Pediatric Age Group

Objective: To find out factors causing shunt malfunction among pediatric patients. Methodology: A Cross-sectional observational study, was conducted at Department of Neurosurgery at Pakistan Institute of Medical Sciences, Islamabad. Patients aged between 1st day of life to 12 years, both gender and raised Intra cranial pressure (ICP) requiring VP shunt placement were included. The patients were followed in the post-operative period till discharge. Shunt malfunction was defined as any condition which compromises the shunt function and requires revision surgery or intervention to correct the shunt function. Data was collected according to self-structured questionnaire and analysis was done on SPSS version 26. Results: Mean age of the patients was 24.29+36.12 months. Males were 84(60.0%) and females were 56(40.0%). Frequency of shunt malfunction was seen in 26(18.60%) of the cases and the most common causative factor was valve malfunction (19.2%), followed by displacement and central nervous system (CNS) infections (each 15.4%). Other causes included proximal catheter obstruction (11.5%), skin infections, and distal catheter obstructions (each 7.7%). Malfunctions occurred most frequently within two weeks post-operation (53.8%). Furthermore, the frequencies of factors responsible, for shunt malfunction were statistically insignificant according to age and gender (p->0.05). Conclusion: The study revealed that 18.60% of pediatric cases experienced shunt malfunction, primarily due to valve malfunction, displacement, central nervous system infections, and catheter obstructions, with most malfunctions occurring within two weeks post-operation.