Document Detail


Outcome for preterm infants with germinal matrix hemorrhage and progressive hydrocephalus.
MedLine Citation:
PMID:  9361065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M L Levy; L S Masri; J G McComb
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  41     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1997-12-22     Completed Date:  1997-12-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1111-7; discussion 1117-8     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, Childrens Hospital of Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
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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