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首页> 外文期刊>Journal of neurosurgery. >Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus.
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Monte Carlo simulation of cerebrospinal fluid shunt failure and definition of instability among shunt-treated patients with hydrocephalus.

机译：脑脊液分流失败的蒙特卡罗模拟和不稳定性定义在经分流治疗的脑积水患者中。

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OBJECT: The authors undertook the present study to estimate the number of operations that patients with hydrocephalus will require within 10 years of diagnosis based on published survival data for cerebrospinal fluid (CSF) shunts. METHODS: Survival data for CSF shunts from several previously published sources were formatted as life tables spanning a 10-year period in monthly intervals. The monthly sequence of fractions of shunts failing was taken as the basis for a Monte Carlo simulation. Month by month for each virtual patient the computer simulation called up a random number between 0 and 1. If the random number was greater than the fraction of shunts failing in that monthly interval, the shunt survived. If the random number was less than or equal to the fraction of shunts failing in that interval, the shunt failed. When a virtual patient's shunt failed, that patient was returned to the first interval in the life table and began again. For every virtual patient this process continued for 120 months, and the number of shunt operations during the 10-year epoch was counted. Probability distributions were estimated for numbers of shunt operations. Expected numbers of shunt operations were calculated, as were the 95th and 99th percentiles. RESULTS: Four sources of CSF shunt survival data were used. Expected numbers of shunt operations ranged between 2.43 and 3.93 over 10 years. Estimated 95th percentiles ranged between five and 11, and estimated 99th percentiles ranged between eight and 15. CONCLUSIONS: New patients with hydrocephalus can expect to undergo between two and four operations for insertion or revision of CSF shunts in the first 10 years after diagnosis. Patients who undergo more than 15 shunt operations in 10 years are statistical outliers. A focused study of such patients may yield useful suggestions for complication avoidance and improvement in the quality of life of children with hydrocephalus.
机译：目的：作者进行了本研究，以根据已公布的脑脊液（CSF）分流存活数据估算脑积水患者在诊断后10年内将需要进行的手术次数。方法：将来自多个先前公开来源的CSF分流器的生存数据格式化为生命表，每个月间隔10年。分流器失效的每月顺序作为蒙特卡罗模拟的基础。对于每个虚拟患者，计算机模拟每个月都会调用一个介于0和1之间的随机数。如果该随机数大于在该月间隔内失败的分流器的分数，则该分流器得以幸存。如果随机数小于或等于在该时间间隔内失败的分流分数，则分流失败。当虚拟患者的分流失败时，该患者将返回到生命表中的第一个间隔并再次开始。对于每个虚拟患者，此过程持续120个月，并计算了10年内的分流手术次数。估计了分流操作次数的概率分布。计算了分流操作的预期数量，以及第95和第99个百分位数。结果：使用了四个来源的脑脊液分流生存数据。在10年中，预期的分流操作次数在2.43至3.93之间。估计的第95个百分位数介于5到11之间，估计的第99个百分位数介于8到15之间。结论：新的脑积水患者可在诊断后的前10年内接受CSF分流器的插入或翻修两次至四次。在10年中进行了15次以上分流手术的患者为统计异常值。对此类患者进行集中研究可能会为避免并发症和改善脑积水儿童的生活质量提供有用的建议。

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