Five-Year Retrospective Cohort Study of Hydrocephalus Incidence and Patient Outcomes in Yogyakarta

Hydrocephalus is characterized by abnormal cerebrospinal fluid (CSF) accumulation in the brain’s ventricles, which can lead to significant morbidity and mortality without timely intervention. This retrospective cohort study aimed to evaluate the incidence, survival outcomes, and risk factors associated with hydrocephalus among patients treated at Bethesda Hospital Yogyakarta over a five-year period. Medical records of 203 patients diagnosed with hydrocephalus between 2019 and 2024 were reviewed, and patient demographics, hydrocephalus type, treatment modality, and comorbidities—assessed using the Charlson Comorbidity Index—were analyzed. Survival outcomes were examined using Kaplan-Meier analysis, and hazard ratios (HR) were calculated via Cox regression. Most patients were aged ≥60 years (60%) and male (53.2%), with non-communicating hydrocephalus being the most common type (43.8%). Infants (<1 year) demonstrated the highest five-year survival rate (100%), while patients aged 41–59 had the lowest (57.1%; HR: 13.8, p = 0.018). Surgical treatment, predominantly ventriculoperitoneal shunting, significantly improved survival (74.0%) compared with conservative management (60.2%; HR: 1.649, p = 0.05). Among hydrocephalus types, ex-vacuo presented the best prognosis (100% survival), whereas non-communicating hydrocephalus had the poorest (63.7%; HR: 14.4, p = 0.016). Higher comorbidity scores were associated with worse outcomes, particularly in acquired cases. Overall, hydrocephalus outcomes varied significantly by age, type, comorbidities, and treatment approach, with surgical intervention offering a clear survival advantage and reinforcing its role as the primary management strategy. Early diagnosis and personalized treatment planning are crucial to improving long-term outcomes in hydrocephalus patients.