• Champeaux DepondCharlesCDepartment of neurosurgery, Clairval Private Hospital, 317 Bd du Redon, 13009 Marseille, France; APHM, INSERM, IRD, SESSTIM, ISSPAM, Hôpital de la Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communicat, Roch Giorgi, Vincent Jecko, and Philippe Metellus.
• Department of neurosurgery, Clairval Private Hospital, 317 Bd du Redon, 13009 Marseille, France; APHM, INSERM, IRD, SESSTIM, ISSPAM, Hôpital de la Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Aix Marseille University, 13005 Marseille, France. Electronic address: https://orcid.org/0000-0002-0356-0893.
• World Neurosurg. 2024 Oct 23.

ObjectiveTo assess the overall survival (OS) of internal cerebrospinal fluid shunt (ICSFS) in the adult population.MethodsMedline database was searched from 2000 to 2023 to identify studies reporting on ICSFS OS. Only articles reporting on adult ICSFS OS by a Kaplan-Meier (KM) OS curve were included. Numerical data were extracted from KM curves and, were then reconstructed to estimate 3, 6, 9, 12, 18, 24, 36, 48 and 60 months restricted mean survival times (RMST). RMST of ICSFS and its standard error (SE) at each time of interest were used as summary measure and primary outcome across studies. To account for the effect of between-study heterogeneity, RMST were pooled using a random effects model.ResultsOut of 421 screened studies, solely 6 were included in the meta-analysis. Calculated ICSFS OS at 3, 6, 12, 18, 24, 36, 48 and 60 months were 92.4%, 95%CI[89.6-95.2]; 89.5%, 95%CI[86.3-92.8]; 87.5%, 95%CI[83.9-91.1]; 85.2%, 95%CI[80.4-90.0]; 83.4%, 95%CI[79.0-87.9]; 81.6%, 95%CI[76.7-86.5]; 78.8%, 95%CI[72.9-84.6]; 76.7%, 95%CI[70.3-83.1]; 74.5%, 95%CI[67.8-81.1] respectively. There was a significant heterogeneity as indicated by a high I2 of 82.5%, 95%CI[63.1-91.7]. Heterogeneity test of Q=28.63 was also significant (p-value<0.001).ConclusionsOn contrary to what one might think, there are few available studies assessing adult ICSFS OS. We used a novel technique to meta-analyse adult ICSFS OS. ICSFS failure rate is maximal within the 3 to 6 post-operative months. Afterwards, the risk slowly decrease over time. At 5 years, less than three quarters of the patients still have a naïve functional ICSFS never revised.Copyright © 2024 Elsevier Inc. All rights reserved.

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