Assessing the Quality of Life in Hydrocephalic Children: A Study from Tertiary Care Hospitals in Pakistan

Abstract

Background Hydrocephalus is a neurological disease with higher prevalence in the pediatric population, often managed by placing a shunt. This hollow tube drains excess cerebrospinal fluid from the brain to other body parts, resulting in several complications, including neurological and psychometric manifestations and a compromised quality of life (QoL). This study aimed to evaluate QoL in patients with hydrocephalus shunt placement within the pediatric population.

Methods This prospective observational study was conducted in two major Pakistani tertiary care hospitals. A total of 100 subjects were enrolled, of which 52 were found eligible. A validated questionnaire, Hydrocephalus Outcome Questionnaire, was used to evaluate patients' QoL.

Results This study included pediatric patients with a mean age of 6.54 years and a standard deviation of ± 2.64. The male-to-female ratio was 27:25; 2% of patients had congenital or tumor-induced hydrocephalus, while cases of meningitis, encephalocele, and encephalitis accounted for 8, 4, and 2%, respectively. Myelomeningocele had the highest prevalence at 16%. The overall health scores range from 0.39 to 0.51. Social, cognitive, and physical health scores have mean values of 0.54, 0.50, and 0.48, respectively. The minimum physical health score is 0.17, indicating the most significant impact of hydrocephalus on physical function.

Conclusion This study highlights variations in hydrocephalus severity among pediatric patients, impacting their overall QoL, primarily physical and behavioral functioning. Worse health outcomes were associated with frequent seizures, prolonged hospital stays for diagnosis and treatment, shunt infections, increased number of shunt catheters, and longer travel distances to medical facilities.

Keywords

hydrocephalus in children - pediatrics - quality-of-life assessment - health outcomes

Authors' Confirmation

It is hereby confirmed that the manuscript has been read and approved by all named authors and that no other persons satisfied the authorship criteria but are not listed. And further confirmed that all have approved the order of authors listed in the manuscript.

Authors' Contribution

A.K. and A.K. conceptualized the study. N.A., S.M., and A.K. contributed to data curation. N.A., A.K., and S.A. performed the formal analysis. N.A. and A.K. investigated the study. N.A., A.K., S.A., and A.K. performed the methodological analysis. A.K., S.M., and A.K. contributed to the project administration. A.K. obtained the resources. A.K. supervised the study. S.M. and N.A. visualized the study. A.K. and N.A. contributed to writing—original draft. A.K., N.A., and A.K. contributed to writing—review and editing.

Data Availability

The original contributions presented in the study are included in the article/supplementary material; further inquiries can be directed to the corresponding authors.

Ethics

The studies involving human participants were reviewed and approved by the Bioethics Committee, Quaid-i-Azam University, Islamabad Ref. no. BEC-FBs-QAU2022–392.

^* These authors contributed equally to this work.

Publication History

Received: 26 April 2024

Accepted: 14 July 2024

Accepted Manuscript online:
16 July 2024

Article published online:
21 August 2024

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