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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(01): 044-051
DOI: 10.1055/s-0044-1779345
Original Article

Hydrocephalus following Brain Tumor Surgery: Factors Correlating with Occurrence of Postoperative Hydrocephalus and Predictive Scoring Model

Raweenut Beangklang
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
2   Department of Surgery, Buriram Hospital, Buriram, Thailand
,
Bunpot Sitthinamsuwan 
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Chottiwat Tansirisithikul
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
,
Sarun Nunta-aree
1   Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Abstract

Hydrocephalus following brain tumor surgery is found, although cause of hydrocephalus is optimally eradicated. This study aimed to investigate factors associated with development of postoperative hydrocephalus that requires shunt procedure and generate predictive scoring model of this condition. Demographic, clinical, radiographic, treatment, laboratory, complication, and postoperative data were collected. Binary logistic regression was used to investigate final model for generating predictive scoring system of postoperative hydrocephalus. A total of 179 patients undergoing brain tumor surgery were included. Forty-five (25.1%) patients had postoperative hydrocephalus that required shunt surgery. In univariate analysis, several factors were found to be associated with postoperative hydrocephalus. Strong predictors of postoperative hydrocephalus revealed in multivariate analysis included tumor recurrence before surgery (odds ratio [OR], 4.38; 95% confidence interval [CI], 1.28–14.98; p = 0.018), preoperative hydrocephalus (OR, 6.52; 95% CI, 2.44–17.46; p < 0.001), glial tumor (OR, 3.76; 95% CI, 1.14–12.43; p = 0.030), metastasis (OR, 5.19; 95% CI, 1.72–15.69; p = 0.004), intraventricular hemorrhage (OR, 7.08; 95% CI, 1.80–27.82; p = 0.005), and residual tumor volume (OR, 1.05; 95% CI, 1.01–1.09; p = 0.007). A cutoff predictive score with the best area under curve and optimum cutoff point was utilized for discriminating patients with high risk from individuals with low risk in occurrence of postoperative hydrocephalus. This study reported predictive factors strongly associated with development of postoperative hydrocephalus. Predictive scoring system is useful for identifying patients with an increased risk of postoperative hydrocephalus. Patients classified in the high-risk group require closed surveillance of the hydrocephalus.

Keywords

postoperative hydrocephalus - brain tumor surgery - incidence - predictive factor - predictive score

Authors' Contributions

R.B. was involved in development or design of methodology, project administration, software, investigation, data collection, formal analysis, visualization, writing- original draft preparation, and approval of the final manuscript. B.S. contributed to conceptualization, development or design of methodology, supervision, formal analysis, writing—reviewing and editing, corresponding author, and approval of the final manuscript. C.T. was involved in writing—reviewing and editing, and approval of the final manuscript. S.N. helped in conceptualization, supervision, writing—reviewing and editing, and approval of the final manuscript.


Ethical Approval

This study was approved by the Ethics Committee of the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand; Certificate of Approval (COA) number SI 753/2017. All the patients' data retained full confidentiality in compliance with the Declaration of Helsinki.




Publication History

Article published online:
26 February 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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