Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection: A multiinstitutional study

Wajd N. Al-Holou, Thomas J. Wilson, Zarina S. Ali, Ryan P. Brennan, Kelly J. Bridges, Tannaz Guivatchian, Ghaith Habboub, Ajit A. Krishnaney, Giuseppe Lanzino, Kendall A. Snyder, Tracy M. Flanders, Khoi D. Than, Aditya S. Pandey

Research output: Contribution to journalArticle

Abstract

OBJECTIVE Gastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions. METHODS A retrospective study of all adult patients admitted to five institutions with a diagnosis of aneurysmal subarachnoid hemorrhage between January 2005 and January 2015 was performed. The primary outcome of interest was ventriculoperitoneal shunt infection. Variables, including gastrostomy tube placement, were tested for their association with this outcome. Standard statistical methods were utilized. RESULTS The overall cohort consisted of 432 patients, 47% of whom had undergone placement of a gastrostomy tube. The overall shunt infection rate was 9%. The only variable that predicted shunt infection was gastrostomy tube placement (p = 0.03, OR 2.09, 95% CI 1.07–4.08), which remained significant in the multivariate analysis (p = 0.04, OR 2.03, 95% CI 1.04–3.97). The greatest proportion of shunts that became infected had been placed more than 2 weeks (25%) and 1–2 weeks (18%) prior to gastrostomy tube placement, but the temporal relationship between shunt and gastrostomy was not a significant predictor of shunt infection. CONCLUSIONS Gastrostomy tube placement significantly increases the risk of ventriculoperitoneal shunt infection.

Original languageEnglish (US)
Pages (from-to)1062-1067
Number of pages6
JournalJournal of neurosurgery
Volume131
Issue number4
DOIs
StatePublished - Oct 2019

Fingerprint

Ventriculoperitoneal Shunt
Gastrostomy
Infection
Peritoneal Cavity
Subarachnoid Hemorrhage
Seeds
Multivariate Analysis
Retrospective Studies
Bacteria

Keywords

  • Cerebrospinal fluid
  • Gastrostomy tube
  • Hydrocephalus
  • Shunt infection
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Al-Holou, W. N., Wilson, T. J., Ali, Z. S., Brennan, R. P., Bridges, K. J., Guivatchian, T., ... Pandey, A. S. (2019). Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection: A multiinstitutional study. Journal of neurosurgery, 131(4), 1062-1067. https://doi.org/10.3171/2018.5.JNS18506

Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection : A multiinstitutional study. / Al-Holou, Wajd N.; Wilson, Thomas J.; Ali, Zarina S.; Brennan, Ryan P.; Bridges, Kelly J.; Guivatchian, Tannaz; Habboub, Ghaith; Krishnaney, Ajit A.; Lanzino, Giuseppe; Snyder, Kendall A.; Flanders, Tracy M.; Than, Khoi D.; Pandey, Aditya S.

In: Journal of neurosurgery, Vol. 131, No. 4, 10.2019, p. 1062-1067.

Research output: Contribution to journalArticle

Al-Holou, WN, Wilson, TJ, Ali, ZS, Brennan, RP, Bridges, KJ, Guivatchian, T, Habboub, G, Krishnaney, AA, Lanzino, G, Snyder, KA, Flanders, TM, Than, KD & Pandey, AS 2019, 'Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection: A multiinstitutional study', Journal of neurosurgery, vol. 131, no. 4, pp. 1062-1067. https://doi.org/10.3171/2018.5.JNS18506
Al-Holou, Wajd N. ; Wilson, Thomas J. ; Ali, Zarina S. ; Brennan, Ryan P. ; Bridges, Kelly J. ; Guivatchian, Tannaz ; Habboub, Ghaith ; Krishnaney, Ajit A. ; Lanzino, Giuseppe ; Snyder, Kendall A. ; Flanders, Tracy M. ; Than, Khoi D. ; Pandey, Aditya S. / Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection : A multiinstitutional study. In: Journal of neurosurgery. 2019 ; Vol. 131, No. 4. pp. 1062-1067.
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abstract = "OBJECTIVE Gastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions. METHODS A retrospective study of all adult patients admitted to five institutions with a diagnosis of aneurysmal subarachnoid hemorrhage between January 2005 and January 2015 was performed. The primary outcome of interest was ventriculoperitoneal shunt infection. Variables, including gastrostomy tube placement, were tested for their association with this outcome. Standard statistical methods were utilized. RESULTS The overall cohort consisted of 432 patients, 47{\%} of whom had undergone placement of a gastrostomy tube. The overall shunt infection rate was 9{\%}. The only variable that predicted shunt infection was gastrostomy tube placement (p = 0.03, OR 2.09, 95{\%} CI 1.07–4.08), which remained significant in the multivariate analysis (p = 0.04, OR 2.03, 95{\%} CI 1.04–3.97). The greatest proportion of shunts that became infected had been placed more than 2 weeks (25{\%}) and 1–2 weeks (18{\%}) prior to gastrostomy tube placement, but the temporal relationship between shunt and gastrostomy was not a significant predictor of shunt infection. CONCLUSIONS Gastrostomy tube placement significantly increases the risk of ventriculoperitoneal shunt infection.",
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T1 - Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection

T2 - A multiinstitutional study

AU - Al-Holou, Wajd N.

AU - Wilson, Thomas J.

AU - Ali, Zarina S.

AU - Brennan, Ryan P.

AU - Bridges, Kelly J.

AU - Guivatchian, Tannaz

AU - Habboub, Ghaith

AU - Krishnaney, Ajit A.

AU - Lanzino, Giuseppe

AU - Snyder, Kendall A.

AU - Flanders, Tracy M.

AU - Than, Khoi D.

AU - Pandey, Aditya S.

PY - 2019/10

Y1 - 2019/10

N2 - OBJECTIVE Gastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions. METHODS A retrospective study of all adult patients admitted to five institutions with a diagnosis of aneurysmal subarachnoid hemorrhage between January 2005 and January 2015 was performed. The primary outcome of interest was ventriculoperitoneal shunt infection. Variables, including gastrostomy tube placement, were tested for their association with this outcome. Standard statistical methods were utilized. RESULTS The overall cohort consisted of 432 patients, 47% of whom had undergone placement of a gastrostomy tube. The overall shunt infection rate was 9%. The only variable that predicted shunt infection was gastrostomy tube placement (p = 0.03, OR 2.09, 95% CI 1.07–4.08), which remained significant in the multivariate analysis (p = 0.04, OR 2.03, 95% CI 1.04–3.97). The greatest proportion of shunts that became infected had been placed more than 2 weeks (25%) and 1–2 weeks (18%) prior to gastrostomy tube placement, but the temporal relationship between shunt and gastrostomy was not a significant predictor of shunt infection. CONCLUSIONS Gastrostomy tube placement significantly increases the risk of ventriculoperitoneal shunt infection.

AB - OBJECTIVE Gastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions. METHODS A retrospective study of all adult patients admitted to five institutions with a diagnosis of aneurysmal subarachnoid hemorrhage between January 2005 and January 2015 was performed. The primary outcome of interest was ventriculoperitoneal shunt infection. Variables, including gastrostomy tube placement, were tested for their association with this outcome. Standard statistical methods were utilized. RESULTS The overall cohort consisted of 432 patients, 47% of whom had undergone placement of a gastrostomy tube. The overall shunt infection rate was 9%. The only variable that predicted shunt infection was gastrostomy tube placement (p = 0.03, OR 2.09, 95% CI 1.07–4.08), which remained significant in the multivariate analysis (p = 0.04, OR 2.03, 95% CI 1.04–3.97). The greatest proportion of shunts that became infected had been placed more than 2 weeks (25%) and 1–2 weeks (18%) prior to gastrostomy tube placement, but the temporal relationship between shunt and gastrostomy was not a significant predictor of shunt infection. CONCLUSIONS Gastrostomy tube placement significantly increases the risk of ventriculoperitoneal shunt infection.

KW - Cerebrospinal fluid

KW - Gastrostomy tube

KW - Hydrocephalus

KW - Shunt infection

KW - Ventriculoperitoneal shunt

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