An algorithm to assess the rehabilitation potential in patients with chronic hydrocephalus

Abstract

Objective: In clinical practice, it is often necessary to judge the probability of clinical benefit of invasive ancillary tests given to patients with chronic hydrocephalus before they are performed. The aim of the current study was to establish a screening tool for such prediction. Material and Methods: A total of 125 patients with chronic hydrocephalus were assessed using a clinical (HHS) and comorbidity (CMI) grading. These patients were shunted and followed-up for at least one year. The statistical tools of ANOVA, CHI-squared, Spearman, Kuskal-Wallis, and Wilcoxen-U-Test were applied. Results: The variables discovered to be of use in prediction were age (p=0.02), anamnesis duration (p=0.04), CMI (p<0.000) and HHS (p=0.001). A decision tree using solely HHS and CMI was established allowing outcome prediction of sufficient power. Interestingly, in patients who had favourable preconditions, older age impeded not a favourable prognosis. Conclusion: With our proposed decision tree, a minimum of data allow a clinician to sufficiently judge whether shunting will be of benefit to a patient, which may help to decide whether invasive ancillary tests are justified. © 2009 Springer-Verlag Vienna.