Evaluation of postoperative complications and mortality predictors in adult patients undergoing ventriculoperitoneal shunt surgery: A retrospective single-center study

Abstract

Aim: The aim of our study is to retrospectively analyze the incidence of postoperative complications in adult patients who underwent ventriculoperitoneal shunt (VPS) surgery for hydrocephalus and to identify clinical, demographic, and surgical predictors of mortality.
Materials and Methods: This is a single-center retrospective analysis including 44 patients aged 18 years and older who underwent primary or revision VPS surgery between September 2021 and January 2025. Data including demographic characteristics, comorbidities, hydrocephalus etiology, type of shunt (programmable vs. standard), clinical presentation, early and late complications, and mortality were collected and analyzed. Statistical analysis involved independent t-tests and chi-square or Fisher’s exact tests as appropriate.
Results: The mean patient age was 68.8 ± 10.8 years, with a mortality rate of 29.5% observed during follow-up. Early and late complication rates were each 13.6%. Over-drainage (9.1%) was the most common early complication, while shunt infection (6.8%) predominated among late complications. Mortality was significantly higher in patients with standard valves (61.5%) compared to those with programmable valves (38.5%, p<0.001). Hydrocephalus secondary to intracranial hemorrhage was associated the highest rate and it was slightly above the significance level (30.8%, p=0.053).
Conclusion: The type of shunt system and hydrocephalus etiology, particularly intracranial hemorrhage, were identified as the most significant predictors of mortality. The use of programmable valve systems and close monitoring of high-risk patients may improve outcomes.