| Outcome for preterm infants with germinal matrix hemorrhage and progressive hydrocephalus. | |
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MedLine Citation:
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PMID: 9361065 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: An analysis of 76 preterm infants with Grade III or IV intracranial hemorrhage and surgically treated progressive hydrocephalus was undertaken to determine mortality, intellectual impairment, and motor deficit. METHODS: The variables examined were degree of prematurity, birth weight, sex, Apgar scores, extent of intracranial hemorrhage, seizures, age at time of initial placement of a ventricular catheter reservoir to control hydrocephalus, need to convert the reservoir to a ventriculoperitoneal shunt, timing of the conversion of the reservoir to a ventriculoperitoneal shunt, and number of shunt revisions. Outcome was assessed for statistical significance using hierarchical linear regression and logistic regression analyses. RESULTS: Linear regression analysis determined that mortality was best predicted, in order of importance, by extent of intracranial hemorrhage, number of shunt revisions, and birth weight (P < 0.0001, R = 0.79). Grade of hemorrhage, weight at birth, and presence of seizure activity were the most important determinants of motor outcome (P < 0.001, R = -0.78). CONCLUSIONS: Logistic regression analysis of the 41 long-term survivors determined that grade of hemorrhage was the most important variable in determining cognitive outcome (P < 0.0001), motor function (P < 0.0001), and presence of seizure activity (P < 0.001). A logistic model of survival determined that grade of hemorrhage and multiple shunt revisions (more than five) were the most important determinants (P < 0.0001) of survival. In conclusion, the overwhelming factor in determining outcome in this patient group was the extent of intracranial hemorrhage. |
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Authors:
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M L Levy; L S Masri; J G McComb |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 41 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 1997 Nov |
Date Detail:
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Created Date: 1997-12-22 Completed Date: 1997-12-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1111-7; discussion 1117-8 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, Childrens Hospital of Los Angeles, California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Apgar Score Birth Weight Cerebral Hemorrhage / physiopathology*, psychology, surgery* Female Follow-Up Studies Gestational Age Humans Hydrocephalus / physiopathology*, psychology, surgery* Infant, Newborn Infant, Premature* Male Motor Activity Prognosis Regression Analysis Seizures / epidemiology Survival Rate Time Factors Ventriculoperitoneal Shunt |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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