Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study
Identifieur interne : 001545 ( Main/Exploration ); précédent : 001544; suivant : 001546Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study
Auteurs : Tamara D. Simon [États-Unis] ; Jerry Butler [États-Unis] ; Kathryn B. Whitlock [États-Unis] ; Samuel R. Browd [États-Unis] ; Richard Holubkov [États-Unis] ; John R. W. Kestle [États-Unis] ; Abhaya V. Kulkarni [Canada] ; Marcie Langley [États-Unis] ; David D. Limbrick [États-Unis] ; Nicole Mayer-Hamblett [États-Unis] ; Mandeep Tamber [États-Unis] ; John C. Wellons ; William E. Whitehead [États-Unis] ; Jay Riva-Cambrin [États-Unis]Source :
- The Journal of pediatrics [ 0022-3476 ] ; 2014.
Descripteurs français
- KwdFr :
- Adolescent, Analyse multivariée, Complications postopératoires (), Complications postopératoires (diagnostic), Complications postopératoires (épidémiologie), Dérivations du liquide céphalorachidien (), Dérivations du liquide céphalorachidien (effets indésirables), Enfant, Enfant d'âge préscolaire, Enregistrements, Femelle, Humains, Hydrocéphalie (), Hydrocéphalie (diagnostic), Incidence, Infection de plaie opératoire (), Infection de plaie opératoire (diagnostic), Infection de plaie opératoire (épidémiologie), Infections bactériennes (), Infections bactériennes (diagnostic), Infections bactériennes (épidémiologie), Liquide cérébrospinal (microbiologie), Modèles de hasards proportionnels, Mâle, Nourrisson, Nouveau-né, Réintervention (), Répartition par sexe, Répartition par âge, Résultat thérapeutique, Études de cohortes, Études de suivi, Études prospectives.
- MESH :
- diagnostic : Complications postopératoires, Hydrocéphalie, Infection de plaie opératoire, Infections bactériennes.
- effets indésirables : Dérivations du liquide céphalorachidien.
- microbiologie : Liquide cérébrospinal.
- épidémiologie : Complications postopératoires, Infection de plaie opératoire, Infections bactériennes.
- Adolescent, Analyse multivariée, Complications postopératoires, Dérivations du liquide céphalorachidien, Enfant, Enfant d'âge préscolaire, Enregistrements, Femelle, Humains, Hydrocéphalie, Incidence, Infection de plaie opératoire, Infections bactériennes, Modèles de hasards proportionnels, Mâle, Nourrisson, Nouveau-né, Réintervention, Répartition par sexe, Répartition par âge, Résultat thérapeutique, Études de cohortes, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Adolescent, Age Distribution, Bacterial Infections (diagnosis), Bacterial Infections (epidemiology), Bacterial Infections (therapy), Cerebrospinal Fluid (microbiology), Cerebrospinal Fluid Shunts (adverse effects), Cerebrospinal Fluid Shunts (methods), Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Hydrocephalus (diagnosis), Hydrocephalus (surgery), Incidence, Infant, Infant, Newborn, Male, Multivariate Analysis, Postoperative Complications (diagnosis), Postoperative Complications (epidemiology), Postoperative Complications (surgery), Proportional Hazards Models, Prospective Studies, Registries, Reoperation (methods), Sex Distribution, Surgical Wound Infection (diagnosis), Surgical Wound Infection (epidemiology), Surgical Wound Infection (surgery), Treatment Outcome.
- MESH :
- adverse effects : Cerebrospinal Fluid Shunts.
- diagnosis : Bacterial Infections, Hydrocephalus, Postoperative Complications, Surgical Wound Infection.
- epidemiology : Bacterial Infections, Postoperative Complications, Surgical Wound Infection.
- methods : Cerebrospinal Fluid Shunts, Reoperation.
- microbiology : Cerebrospinal Fluid.
- surgery : Hydrocephalus, Postoperative Complications, Surgical Wound Infection.
- therapy : Bacterial Infections.
- Adolescent, Age Distribution, Child, Child, Preschool, Cohort Studies, Female, Follow-Up Studies, Humans, Incidence, Infant, Infant, Newborn, Male, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Registries, Sex Distribution, Treatment Outcome.
Abstract
To quantify the extent to which revision(s) of cerebrospinal fluid (CSF) shunt are associated with increased risk of CSF shunt infection, after adjusting for patient factors that may contribute to infection risk.
We used the HCRN registry to assemble a large prospective six center cohort of 1,036 children undergoing initial CSF shunt placement between April 2008 and January 2012. The primary outcome of interest was first CSF shunt infection. Data for initial CSF shunt placement and all subsequent CSF shunt revisions prior to first CSF shunt infection, where applicable, were obtained. The risk of first infection was estimated using a multivariable Cox proportional hazard model accounting for patient characteristics and CSF shunt revisions, and is reported using hazard ratios (HR) with 95% confidence intervals (CI).
Of the 102 children who developed first infection within 12 months of placement, 33 (32%) followed one or more CSF shunt revisions. Baseline factors independently associated with risk of first infection included: gastrostomy tube (HR 2.0, 95% CI: 1.1, 3.3), age 6–12 months (HR 0.3, 95% CI: 0.1, 0.8), and prior neurosurgery (HR 0.4, 95% CI: 0.2, 0.9). After controlling for baseline factors, infection risk was most significantly associated with the need for revision (1 revision vs. none, HR 3.9, 95% CI: 2.2, 6.5; ≥2 revisions, HR 13.0, 95% CI: 6.5, 24.9).
This study quantifies the elevated risk of infection associated with shunt revisions observed in clinical practice. To reduce risk of infection risk further work should optimize revision procedures.
Url:
DOI: 10.1016/j.jpeds.2014.02.013
PubMed: 24661340
PubMed Central: 4035376
Affiliations:
- Canada, États-Unis
- Missouri (État), Ontario, Pennsylvanie, Texas, Utah, Washington (État)
- Toronto
- Université de Toronto
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000E80
- to stream Pmc, to step Curation: 000E55
- to stream Pmc, to step Checkpoint: 000699
- to stream PubMed, to step Corpus: 002C12
- to stream PubMed, to step Curation: 002B96
- to stream PubMed, to step Checkpoint: 002B96
- to stream Ncbi, to step Merge: 001754
- to stream Ncbi, to step Curation: 001754
- to stream Ncbi, to step Checkpoint: 001754
- to stream Main, to step Merge: 001582
- to stream Main, to step Curation: 001545
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study</title><author><name sortKey="Simon, Tamara D" sort="Simon, Tamara D" uniqKey="Simon T" first="Tamara D." last="Simon">Tamara D. Simon</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Butler, Jerry" sort="Butler, Jerry" uniqKey="Butler J" first="Jerry" last="Butler">Jerry Butler</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Pediatrics, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Department of Pediatrics, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Whitlock, Kathryn B" sort="Whitlock, Kathryn B" uniqKey="Whitlock K" first="Kathryn B." last="Whitlock">Kathryn B. Whitlock</name><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Browd, Samuel R" sort="Browd, Samuel R" uniqKey="Browd S" first="Samuel R." last="Browd">Samuel R. Browd</name><affiliation wicri:level="2"><nlm:aff id="A4">Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Holubkov, Richard" sort="Holubkov, Richard" uniqKey="Holubkov R" first="Richard" last="Holubkov">Richard Holubkov</name><affiliation wicri:level="2"><nlm:aff id="A4">Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Kestle, John R W" sort="Kestle, John R W" uniqKey="Kestle J" first="John R. W." last="Kestle">John R. W. Kestle</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Kulkarni, Abhaya V" sort="Kulkarni, Abhaya V" uniqKey="Kulkarni A" first="Abhaya V." last="Kulkarni">Abhaya V. Kulkarni</name><affiliation wicri:level="4"><nlm:aff id="A6">Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Langley, Marcie" sort="Langley, Marcie" uniqKey="Langley M" first="Marcie" last="Langley">Marcie Langley</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Limbrick, David D" sort="Limbrick, David D" uniqKey="Limbrick D" first="David D." last="Limbrick">David D. Limbrick</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Neurosurgery, St. Louis Children’s Hospital, Washington University in Saint Louis, St. Louis, Missouri</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, St. Louis Children’s Hospital, Washington University in Saint Louis, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Mayer Hamblett, Nicole" sort="Mayer Hamblett, Nicole" uniqKey="Mayer Hamblett N" first="Nicole" last="Mayer-Hamblett">Nicole Mayer-Hamblett</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Tamber, Mandeep" sort="Tamber, Mandeep" uniqKey="Tamber M" first="Mandeep" last="Tamber">Mandeep Tamber</name><affiliation wicri:level="2"><nlm:aff id="A8">Division of Neurosurgery, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Division of Neurosurgery, Children’s Hospital of Pittsburgh, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Wellons, John C" sort="Wellons, John C" uniqKey="Wellons J" first="John C." last="Wellons">John C. Wellons</name><affiliation><nlm:aff id="A9">Section of Pediatric Neurosurgery, Children’s Hospital of Alabama, Division of Neurosurgery, University of Alabama – Birmingham, Birmingham, Alabama (during this work, currently at Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee)</nlm:aff><wicri:noCountry code="subfield">Tennessee)</wicri:noCountry></affiliation></author><author><name sortKey="Whitehead, William E" sort="Whitehead, William E" uniqKey="Whitehead W" first="William E." last="Whitehead">William E. Whitehead</name><affiliation wicri:level="2"><nlm:aff id="A10">Division of Pediatric Neurosurgery, Texas Children’s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Texas Children’s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Riva Cambrin, Jay" sort="Riva Cambrin, Jay" uniqKey="Riva Cambrin J" first="Jay" last="Riva-Cambrin">Jay Riva-Cambrin</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24661340</idno><idno type="pmc">4035376</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035376</idno><idno type="RBID">PMC:4035376</idno><idno type="doi">10.1016/j.jpeds.2014.02.013</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000E80</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E80</idno><idno type="wicri:Area/Pmc/Curation">000E55</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000E55</idno><idno type="wicri:Area/Pmc/Checkpoint">000699</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000699</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">002C12</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002C12</idno><idno type="wicri:Area/PubMed/Curation">002B96</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002B96</idno><idno type="wicri:Area/PubMed/Checkpoint">002B96</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002B96</idno><idno type="wicri:Area/Ncbi/Merge">001754</idno><idno type="wicri:Area/Ncbi/Curation">001754</idno><idno type="wicri:Area/Ncbi/Checkpoint">001754</idno><idno type="wicri:doubleKey">0022-3476:2014:Simon T:risk:factors:for</idno><idno type="wicri:Area/Main/Merge">001582</idno><idno type="wicri:Area/Main/Curation">001545</idno><idno type="wicri:Area/Main/Exploration">001545</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study</title><author><name sortKey="Simon, Tamara D" sort="Simon, Tamara D" uniqKey="Simon T" first="Tamara D." last="Simon">Tamara D. Simon</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Butler, Jerry" sort="Butler, Jerry" uniqKey="Butler J" first="Jerry" last="Butler">Jerry Butler</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Pediatrics, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Department of Pediatrics, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Whitlock, Kathryn B" sort="Whitlock, Kathryn B" uniqKey="Whitlock K" first="Kathryn B." last="Whitlock">Kathryn B. Whitlock</name><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Browd, Samuel R" sort="Browd, Samuel R" uniqKey="Browd S" first="Samuel R." last="Browd">Samuel R. Browd</name><affiliation wicri:level="2"><nlm:aff id="A4">Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Holubkov, Richard" sort="Holubkov, Richard" uniqKey="Holubkov R" first="Richard" last="Holubkov">Richard Holubkov</name><affiliation wicri:level="2"><nlm:aff id="A4">Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Kestle, John R W" sort="Kestle, John R W" uniqKey="Kestle J" first="John R. W." last="Kestle">John R. W. Kestle</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Kulkarni, Abhaya V" sort="Kulkarni, Abhaya V" uniqKey="Kulkarni A" first="Abhaya V." last="Kulkarni">Abhaya V. Kulkarni</name><affiliation wicri:level="4"><nlm:aff id="A6">Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Langley, Marcie" sort="Langley, Marcie" uniqKey="Langley M" first="Marcie" last="Langley">Marcie Langley</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author><author><name sortKey="Limbrick, David D" sort="Limbrick, David D" uniqKey="Limbrick D" first="David D." last="Limbrick">David D. Limbrick</name><affiliation wicri:level="2"><nlm:aff id="A7">Department of Neurosurgery, St. Louis Children’s Hospital, Washington University in Saint Louis, St. Louis, Missouri</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Department of Neurosurgery, St. Louis Children’s Hospital, Washington University in Saint Louis, St. Louis</wicri:cityArea></affiliation></author><author><name sortKey="Mayer Hamblett, Nicole" sort="Mayer Hamblett, Nicole" uniqKey="Mayer Hamblett N" first="Nicole" last="Mayer-Hamblett">Nicole Mayer-Hamblett</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Department of Pediatrics, University of Washington/ Seattle Children’s Hospital, Seattle</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Washington (État)</region></placeName><wicri:cityArea>Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle</wicri:cityArea></affiliation></author><author><name sortKey="Tamber, Mandeep" sort="Tamber, Mandeep" uniqKey="Tamber M" first="Mandeep" last="Tamber">Mandeep Tamber</name><affiliation wicri:level="2"><nlm:aff id="A8">Division of Neurosurgery, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Division of Neurosurgery, Children’s Hospital of Pittsburgh, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Wellons, John C" sort="Wellons, John C" uniqKey="Wellons J" first="John C." last="Wellons">John C. Wellons</name><affiliation><nlm:aff id="A9">Section of Pediatric Neurosurgery, Children’s Hospital of Alabama, Division of Neurosurgery, University of Alabama – Birmingham, Birmingham, Alabama (during this work, currently at Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee)</nlm:aff><wicri:noCountry code="subfield">Tennessee)</wicri:noCountry></affiliation></author><author><name sortKey="Whitehead, William E" sort="Whitehead, William E" uniqKey="Whitehead W" first="William E." last="Whitehead">William E. Whitehead</name><affiliation wicri:level="2"><nlm:aff id="A10">Division of Pediatric Neurosurgery, Texas Children’s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Texas Children’s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Riva Cambrin, Jay" sort="Riva Cambrin, Jay" uniqKey="Riva Cambrin J" first="Jay" last="Riva-Cambrin">Jay Riva-Cambrin</name><affiliation wicri:level="2"><nlm:aff id="A5">Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City, Utah</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Utah</region></placeName><wicri:cityArea>Division of Pediatric Neurosurgery, Primary Children’s Medical Center, Department of Neurosurgery, University of Utah, Salt Lake City</wicri:cityArea></affiliation></author></analytic><series><title level="j">The Journal of pediatrics</title><idno type="ISSN">0022-3476</idno><idno type="eISSN">1097-6833</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Age Distribution</term><term>Bacterial Infections (diagnosis)</term><term>Bacterial Infections (epidemiology)</term><term>Bacterial Infections (therapy)</term><term>Cerebrospinal Fluid (microbiology)</term><term>Cerebrospinal Fluid Shunts (adverse effects)</term><term>Cerebrospinal Fluid Shunts (methods)</term><term>Child</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hydrocephalus (diagnosis)</term><term>Hydrocephalus (surgery)</term><term>Incidence</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Multivariate Analysis</term><term>Postoperative Complications (diagnosis)</term><term>Postoperative Complications (epidemiology)</term><term>Postoperative Complications (surgery)</term><term>Proportional Hazards Models</term><term>Prospective Studies</term><term>Registries</term><term>Reoperation (methods)</term><term>Sex Distribution</term><term>Surgical Wound Infection (diagnosis)</term><term>Surgical Wound Infection (epidemiology)</term><term>Surgical Wound Infection (surgery)</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Analyse multivariée</term><term>Complications postopératoires ()</term><term>Complications postopératoires (diagnostic)</term><term>Complications postopératoires (épidémiologie)</term><term>Dérivations du liquide céphalorachidien ()</term><term>Dérivations du liquide céphalorachidien (effets indésirables)</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Enregistrements</term><term>Femelle</term><term>Humains</term><term>Hydrocéphalie ()</term><term>Hydrocéphalie (diagnostic)</term><term>Incidence</term><term>Infection de plaie opératoire ()</term><term>Infection de plaie opératoire (diagnostic)</term><term>Infection de plaie opératoire (épidémiologie)</term><term>Infections bactériennes ()</term><term>Infections bactériennes (diagnostic)</term><term>Infections bactériennes (épidémiologie)</term><term>Liquide cérébrospinal (microbiologie)</term><term>Modèles de hasards proportionnels</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Réintervention ()</term><term>Répartition par sexe</term><term>Répartition par âge</term><term>Résultat thérapeutique</term><term>Études de cohortes</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Cerebrospinal Fluid Shunts</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Bacterial Infections</term><term>Hydrocephalus</term><term>Postoperative Complications</term><term>Surgical Wound Infection</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Complications postopératoires</term><term>Hydrocéphalie</term><term>Infection de plaie opératoire</term><term>Infections bactériennes</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Dérivations du liquide céphalorachidien</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Bacterial Infections</term><term>Postoperative Complications</term><term>Surgical Wound Infection</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Cerebrospinal Fluid Shunts</term><term>Reoperation</term></keywords><keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Liquide cérébrospinal</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Cerebrospinal Fluid</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Hydrocephalus</term><term>Postoperative Complications</term><term>Surgical Wound Infection</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Bacterial Infections</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Complications postopératoires</term><term>Infection de plaie opératoire</term><term>Infections bactériennes</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Age Distribution</term><term>Child</term><term>Child, Preschool</term><term>Cohort Studies</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Infant</term><term>Infant, Newborn</term><term>Male</term><term>Multivariate Analysis</term><term>Proportional Hazards Models</term><term>Prospective Studies</term><term>Registries</term><term>Sex Distribution</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Analyse multivariée</term><term>Complications postopératoires</term><term>Dérivations du liquide céphalorachidien</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Enregistrements</term><term>Femelle</term><term>Humains</term><term>Hydrocéphalie</term><term>Incidence</term><term>Infection de plaie opératoire</term><term>Infections bactériennes</term><term>Modèles de hasards proportionnels</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Réintervention</term><term>Répartition par sexe</term><term>Répartition par âge</term><term>Résultat thérapeutique</term><term>Études de cohortes</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P2">To quantify the extent to which revision(s) of cerebrospinal fluid (CSF) shunt are associated with increased risk of CSF shunt infection, after adjusting for patient factors that may contribute to infection risk.</p></sec><sec id="S2"><title>Study design</title><p id="P3">We used the HCRN registry to assemble a large prospective six center cohort of 1,036 children undergoing initial CSF shunt placement between April 2008 and January 2012. The primary outcome of interest was first CSF shunt infection. Data for initial CSF shunt placement and all subsequent CSF shunt revisions prior to first CSF shunt infection, where applicable, were obtained. The risk of first infection was estimated using a multivariable Cox proportional hazard model accounting for patient characteristics and CSF shunt revisions, and is reported using hazard ratios (HR) with 95% confidence intervals (CI).</p></sec><sec id="S3"><title>Results</title><p id="P4">Of the 102 children who developed first infection within 12 months of placement, 33 (32%) followed one or more CSF shunt revisions. Baseline factors independently associated with risk of first infection included: gastrostomy tube (HR 2.0, 95% CI: 1.1, 3.3), age 6–12 months (HR 0.3, 95% CI: 0.1, 0.8), and prior neurosurgery (HR 0.4, 95% CI: 0.2, 0.9). After controlling for baseline factors, infection risk was most significantly associated with the need for revision (1 revision vs. none, HR 3.9, 95% CI: 2.2, 6.5; ≥2 revisions, HR 13.0, 95% CI: 6.5, 24.9).</p></sec><sec id="S4"><title>Conclusions</title><p id="P5">This study quantifies the elevated risk of infection associated with shunt revisions observed in clinical practice. To reduce risk of infection risk further work should optimize revision procedures.</p></sec></div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Missouri (État)</li><li>Ontario</li><li>Pennsylvanie</li><li>Texas</li><li>Utah</li><li>Washington (État)</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Wellons, John C" sort="Wellons, John C" uniqKey="Wellons J" first="John C." last="Wellons">John C. Wellons</name></noCountry><country name="États-Unis"><region name="Washington (État)"><name sortKey="Simon, Tamara D" sort="Simon, Tamara D" uniqKey="Simon T" first="Tamara D." last="Simon">Tamara D. Simon</name></region><name sortKey="Browd, Samuel R" sort="Browd, Samuel R" uniqKey="Browd S" first="Samuel R." last="Browd">Samuel R. Browd</name><name sortKey="Butler, Jerry" sort="Butler, Jerry" uniqKey="Butler J" first="Jerry" last="Butler">Jerry Butler</name><name sortKey="Holubkov, Richard" sort="Holubkov, Richard" uniqKey="Holubkov R" first="Richard" last="Holubkov">Richard Holubkov</name><name sortKey="Kestle, John R W" sort="Kestle, John R W" uniqKey="Kestle J" first="John R. W." last="Kestle">John R. W. Kestle</name><name sortKey="Langley, Marcie" sort="Langley, Marcie" uniqKey="Langley M" first="Marcie" last="Langley">Marcie Langley</name><name sortKey="Limbrick, David D" sort="Limbrick, David D" uniqKey="Limbrick D" first="David D." last="Limbrick">David D. Limbrick</name><name sortKey="Mayer Hamblett, Nicole" sort="Mayer Hamblett, Nicole" uniqKey="Mayer Hamblett N" first="Nicole" last="Mayer-Hamblett">Nicole Mayer-Hamblett</name><name sortKey="Mayer Hamblett, Nicole" sort="Mayer Hamblett, Nicole" uniqKey="Mayer Hamblett N" first="Nicole" last="Mayer-Hamblett">Nicole Mayer-Hamblett</name><name sortKey="Riva Cambrin, Jay" sort="Riva Cambrin, Jay" uniqKey="Riva Cambrin J" first="Jay" last="Riva-Cambrin">Jay Riva-Cambrin</name><name sortKey="Simon, Tamara D" sort="Simon, Tamara D" uniqKey="Simon T" first="Tamara D." last="Simon">Tamara D. Simon</name><name sortKey="Tamber, Mandeep" sort="Tamber, Mandeep" uniqKey="Tamber M" first="Mandeep" last="Tamber">Mandeep Tamber</name><name sortKey="Whitehead, William E" sort="Whitehead, William E" uniqKey="Whitehead W" first="William E." last="Whitehead">William E. Whitehead</name><name sortKey="Whitlock, Kathryn B" sort="Whitlock, Kathryn B" uniqKey="Whitlock K" first="Kathryn B." last="Whitlock">Kathryn B. Whitlock</name></country><country name="Canada"><region name="Ontario"><name sortKey="Kulkarni, Abhaya V" sort="Kulkarni, Abhaya V" uniqKey="Kulkarni A" first="Abhaya V." last="Kulkarni">Abhaya V. Kulkarni</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001545 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 001545 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Amérique
|area= PittsburghV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:4035376
|texte= Risk factors for first cerebrospinal fluid shunt infection: findings from a multi-center prospective cohort study
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:24661340" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a PittsburghV1
| This area was generated with Dilib version V0.6.38. |  |