Implanted Ventricular Shunts in the United States: The Billion-dollar-a-year Cost of Hydrocephalus Treatment

• DOI: 10.1227/01.neu.0000146206.40375.41
• Publication Date: 2016-07-25T04:57:58Z
• Authors: Ravish V. Patwardhan; Anil Nanda
• Keywords: Ventriculostomy

Abstract OBJECTIVE: To characterize admissions related to ventricular shunts in the year 2000 terms of diagnoses, procedures, socioeconomic status, and other data. METHODS: The Nationwide Inpatient Sample database (year 2000) was analyzed retrospectively. We reviewed 7.45 million patient for primary International Classification Diseases, 9th Revision, procedure codes 023 0243 (ventricular peritoneal, atrial, pleural, urinary systems initial placement, revision, removal); listing ventriculostomy placement (code 022) were excluded from analysis. RESULTS: Five thousand five hundred seventy-four identified. Admission sources primarily routine (58.8%) emergency department (32.4%). types elective (43.3%), emergent (33.2%), urgent (21.9%). top three diagnoses treated shunt malfunction (40.7%), noncommunicating hydrocephalus (16.6%), communicating (13.2%). Shunt infection diagnosis 7.2% admissions. Age frequency nonparametric, being highest infants; average stay 8.4 ± 0.2 days (standard error range, 0–243 d). most common procedures ventriculoperitoneal (43.4%) replacement (42.8%); removal occurred 7.3% admissions, whereas ventricle-to-thorax (0.6%), ventricle-to-circulatory system (0.5%), ventricle-to-urinary (0.05%) rare. Average cost $35,816 $810 $137–$814,748). Primary payers private insurers (43.8%), Medicare (26.0%), Medicaid (24.5%). Disposition mainly (78.4%, with home health care 6.5%), inpatient mortality 2.7%. There no disproportion treatment respect household income. CONCLUSION: Ventricular as constitute a significant medical economic problem.