Risk Factors for 30-Day Postoperative Infection in Pediatric Ventricular Shunts for Hydrocephalus
Bibliographic record
Abstract
BACKGROUND: Ventricular shunt infections lead to significant morbidity and mortality. This study aimed to identify risk factors for 30-day postoperative infection outcomes of ventricular shunt surgery for pediatric hydrocephalus. METHODS: This retrospective cohort study used the National Surgical Quality Improvement Program Pediatric database for the years 2016-2021. Patients were included in this study if they were <18 years old and underwent ventricular shunt surgery. The primary outcome was 30-day postoperative shunt infection. A multivariable logistic regression analysis was performed using 14 prognostic variables to determine factors associated with infection risk. RESULTS: The study included 10,878 patients with a mean (SD) age of 3.1 (4.83) years; 44.2% were girls. The overall 30-day postoperative shunt infection rate was 3.7%. Infection risk increased in patients with nutritional support, longer operating room time, and congenital hydrocephalus. Conversely, infection risk decreased with increasing patient age, delivery of intraoperative intraventricular antibiotics, and first-time shunt placement. Variables that did not significantly affect the risk of 30-day postoperative shunt infection included sex, body mass index, ostomy, tracheostomy, neuromuscular disease, structural pulmonary/airway abnormality, steroid use within 30 days, antibiotic-impregnated shunt use, and endoscopy for catheter placement. CONCLUSIONS: Various modifiable and nonmodifiable factors are associated with postoperative shunt infections. Recognizing and modifying risk factors can reduce pediatric shunt infections, thereby preventing revisions and improving therapeutic outcomes and quality of life.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".