Hospital Costs Associated With Shunt Infections in Patients Receiving Antibiotic-Impregnated Shunt Catheters Versus Standard Shunt Catheters

Neurosurgery ◽  
2010 ◽  
Vol 66 (2) ◽  
pp. 284-289 ◽  
Author(s):  
Frank J. Attenello ◽  
Giannina L. Garces-Ambrossi ◽  
Hasan A. Zaidi ◽  
Daniel M. Sciubba ◽  
George I. Jallo
Keyword(s):  
Hospital Cost ◽  
Pediatric Patients ◽  
Hospital Costs ◽  
The United States ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Csf Shunts ◽  
Shunt Infections

Abstract BACKGROUND The average hospital cost for shunt infection treatment is $50 000, making it the most financially costly implant-related infection in the United States. We set out to determine whether introduction of antibiotic-impregnated shunts (AISs) in our practice has decreased the incidence of shunt infection or decreased infection-related hospital costs at our institution. METHODS Clinical and hospital billing records of pediatric patients undergoing cerebrospinal fluid (CSF) shunt insertion at a single institution from April 2001 to December 2006 were retrospectively reviewed. Eighteen months before October 2002, all CSF shunts included standard, non-AIS catheters. During the 4 years after October 2002, all CSF shunts included AIS catheters. Patients were followed at least 18 months after surgery. RESULTS A total of 406 pediatric patients underwent 608 shunt placement procedures (400 AISs, 208 non-AISs). Of patients with non-AIS catheters, 25 (12%) experienced shunt infection, whereas only 13 patients (3.2%) with AIS catheters experienced shunt infection during follow-up (P < .001). The total hospital cost to treat 25 non-AIS shunt infections over the first 18 months was $1,234,928. The total hospital cost to treat 13 AIS shunt infections over the past 4 years was $606,328. The mean hospital cost per shunt infection was similar for infected AIS and non-AIS catheters ($46 640 vs. $49 397). However, the infection-related hospital cost per 100 patients shunted was markedly lower in the AIS cohort than in the non-AIS cohort ($151 582 vs. $593 715). DISCUSSION The introduction of AIS catheters in our institutional practice reduced the incidence of shunt infection and resulted in significant hospital cost savings. AIS systems are efficient and cost-effective instruments to prevent perioperative colonization of CSF shunt components.

Total Hospital Costs and Readmission Rate of Patient-Specific Instrument in Total Knee Arthroplasty Patients

2020 ◽  
Author(s):  
Stephen Thomas ◽  
Ankur Patel ◽  
Corey Patrick ◽  
Gary Delhougne
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Hospital Cost ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Patient Specific ◽  
P Value ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Knee

AbstractDespite advancements in surgical technique and component design, implant loosening, stiffness, and instability remain leading causes of total knee arthroplasty (TKA) failure. Patient-specific instruments (PSI) aid in surgical precision and in implant positioning and ultimately reduce readmissions and revisions in TKA. The objective of the study was to evaluate total hospital cost and readmission rate at 30, 60, 90, and 365 days in PSI-guided TKA patients. We retrospectively reviewed patients who underwent a primary TKA for osteoarthritis from the Premier Perspective Database between 2014 and 2017 Q2. TKA with PSI patients were identified using appropriate keywords from billing records and compared against patients without PSI. Patients were excluded if they were < 21 years of age; outpatient hospital discharges; evidence of revision TKA; bilateral TKA in same discharge or different discharges. 1:1 propensity score matching was used to control patients, hospital, and clinical characteristics. Generalized Estimating Equation model with appropriate distribution and link function were used to estimate hospital related cost while logistic regression models were used to estimate 30, 60, and 90 days and 1-year readmission rate. The study matched 3,358 TKAs with PSI with TKA without PSI patients. Mean total hospital costs were statistically significantly (p < 0.0001) lower for TKA with PSI ($14,910; 95% confidence interval [CI]: $14,735–$15,087) than TKA without PSI patients ($16,018; 95% CI: $15,826–$16,212). TKA with PSI patients were 31% (odds ratio [OR]: 0.69; 95% CI: 0.51–0.95; p-value = 0.0218) less likely to be readmitted at 30 days; 35% (OR: 0.65; 95% CI: 0.50–0.86; p-value = 0.0022) less likely to be readmitted at 60 days; 32% (OR: 0.68; 95% CI: 0.53–0.88; p-value = 0.0031) less likely to be readmitted at 90 days; 28% (OR: 0.72; 95% CI: 0.60–0.86; p-value = 0.0004) less likely to be readmitted at 365 days than TKA without PSI patients. Hospitals and health care professionals can use retrospective real-world data to make informed decisions on using PSI to reduce hospital cost and readmission rate, and improve outcomes in TKA patients.

Abstract 258: Dabigatran Etexilate is Associated with Shorter Hospital Length of Stay and Lower Hospital Costs Compared to Warfarin in Treatment-Naive, Newly-Diagnosed Nonvalvular Atrial Fibrillation Patients

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Eileen Fonseca ◽  
David R Walker ◽  
Gregory P Hess
Keyword(s):  
Atrial Fibrillation ◽  
Hospital Cost ◽  
Dabigatran Etexilate ◽  
Hospital Costs ◽  
Hospital Length Of Stay ◽  
Total Hospital Cost ◽  
Newly Diagnosed ◽  
Nonvalvular Atrial Fibrillation ◽  
Total Hospital ◽  
Treatment Naïve

Background: Warfarin and dabigatran etexilate (DE) are oral anticoagulants (OAC) used to reduce the risk of stroke among patients with nonvalvular atrial fibrillation (AF). However, DE does not require titration and INR monitoring. This study examined whether hospital length of stay (LOS) and total hospital costs differed between the two therapies among treatment-naive, newly-diagnosed AF patients. Methods: LOS and total hospital costs were evaluated for hospitalizations with a primary or secondary discharge diagnosis of atrial fibrillation (AF) between 1/1/2011-3/31/2012, with DE or warfarin administered during hospitalization, and excluding hospitalizations of patients with valvular AF, previously diagnosed with AF, or previously treated with OAC. Hospitalizations were identified from a Charge Detail Masters database containing 397 qualified hospitals. Samples were propensity score matched using nearest neighbor within a caliper of 0.20 standard deviations of the logit, without replacement and a 2:1 match. Differences in LOS and hospital cost were then estimated using generalized linear models, fitted by generalized estimating equations (clustered by hospital) to account for possible correlation between observations. The hospitalization’s charged amount was multiplied by the hospital’s inpatient cost-to-charge ratio to estimate the total hospital cost. Covariates estimating the propensity score, LOS, and costs included patient age, payer type, CHADS 2 and HAS-BLED scores, use of bridging agents, comorbid conditions, and hospital attributes. As a sensitivity analysis, LOS and costs were estimated with the same parameters and covariates among the raw, unbalanced sample. Results: Matched samples included 1,292 warfarin and 646 DE hospitalizations of treatment-naive, newly diagnosed patients out of 4,619 and 715 hospitalizations, respectively. No covariates used in matching had standardized mean differences > 10% after matching. Two comorbidities (thromboembolism, coronary artery disease) had statistically different distributions after matching (DE: 3% vs. warfarin: 8%, p<0.001 and DE: 40% vs. warfarin: 45%, p=0.048); these were included as model covariates. Among the sample, DE had an estimated 0.7 days shorter stay compared to warfarin (DE: 4.8 days vs. warfarin: 5.5 days, p<0.01) and a $2,031 lower estimated total cost (DE: $14,794 vs warfarin: $16,826, p=0.007). Sensitivity analysis confirmed a shorter DE LOS (DE: 5.5 days vs. warfarin: 6.6 days, delta=1.1 days, p<0.01) and a lower DE hospital cost (DE: $18,362 vs. warfarin: $22,602, delta=$4,240, p<0.01). Conclusions: Among hospitalizations of treatment-naive patients newly diagnosed with nonvalvular AF, the hospitalizations during which DE was administered had a shorter LOS and at least a 12% lower total hospital cost compared to hospitalizations where warfarin was administered.

scholarly journals Infection rates following initial cerebrospinal fluid shunt placement across pediatric hospitals in the United States

2009 ◽  
Vol 4 (2) ◽  
pp. 156-165 ◽  
Author(s):  
Tamara D. Simon ◽  
Matthew Hall ◽  
Jay Riva-Cambrin ◽  
J. Elaine Albert ◽  
Howard E. Jeffries ◽  
...  
Keyword(s):  
The United States ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Infection Rates ◽  
Study Objective ◽  
Shunt Placement ◽  
Pediatric Hospitals ◽  
Csf Shunt Infection ◽  
Shunt Infections

Object Reported rates of CSF shunt infection vary widely across studies. The study objective was to determine the CSF shunt infection rates after initial shunt placement at multiple US pediatric hospitals. The authors hypothesized that infection rates between hospitals would vary widely even after adjustment for patient, hospital, and surgeon factors. Methods This retrospective cohort study included children 0–18 years of age with uncomplicated initial CSF shunt placement performed between January 1, 2001, and December 31, 2005, and recorded in the Pediatric Health Information System (PHIS) longitudinal administrative database from 41 children's hospitals. For each child with 24 months of follow-up, subsequent CSF shunt infections and procedures were determined. Results The PHIS database included 7071 children with uncomplicated initial CSF shunt placement during this time period. During the 24 months of follow-up, these patients had a total of 825 shunt infections and 4434 subsequent shunt procedures. Overall unadjusted 24-month CSF shunt infection rates were 11.7% per patient and 7.2% per procedure. Unadjusted 24-month cumulative incidence rates for each hospital ranged from 4.1 to 20.5% per patient and 2.5–12.3% per procedure. Factors significantly associated with infection (p < 0.05) included young age, female sex, African-American race, public insurance, etiology of intraventricular hemorrhage, respiratory complex chronic condition, subsequent revision procedures, hospital volume, and surgeon case volume. Malignant lesions and trauma as etiologies were protective. Infection rates for each hospital adjusted for these factors decreased to 8.8–12.8% per patient and 1.4–5.3% per procedure. Conclusions Infections developed in > 11% of children who underwent uncomplicated initial CSF shunt placements within 24 months. Patient, hospital, and surgeon factors contributed somewhat to the wide variation in CSF shunt infection rates across hospitals. Additional factors may contribute to variation in CSF shunt infection rates between centers, but further study is needed. Benchmarking and future prospective multicenter studies of CSF shunt infection will need to incorporate these and other patient, hospital, and surgeon factors.

Factors contributing to the medical costs of cerebrospinal fluid shunt infection treatment in pediatric patients with standard shunt components compared with those in patients with antibiotic-impregnated components

2007 ◽  
Vol 22 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Daniel M. Sciubba ◽  
Li-Mei Lin ◽  
Graeme F. Woodworth ◽  
Matthew J. McGirt ◽  
Benjamin Carson ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Medical Costs ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Shunt Insertion ◽  
Average Hospital ◽  
Infection Treatment ◽  
Shunt Infections

Object Antibiotic-impregnated shunt (AIS) systems may decrease the incidence of cerebrospinal fluid (CSF) shunt infections. However, there is a reluctance to use AIS components because of their increased cost. In the present study the authors evaluated factors contributing to the medical costs associated with the treatment of CSF shunt infections in a hydrocephalic pediatric population, those implanted with AIS systems compared with those implanted with standard shunt systems. Methods The authors retrospectively reviewed data obtained in all pediatric patients who had undergone CSF shunt insertion at their institution over a 3-year period. All patients were followed up for 12 months after surgery. The independent association between AIS catheter use and subsequent shunt infection was assessed by performing a multivariate proportional hazards regression analysis. Factors contributing to the medical costs associated with shunt infection were evaluated. Results Two hundred eleven pediatric patients underwent 353 shunting procedures. Two hundred eight shunts (59%) were placed with nonimpregnated catheters and 145 shunts (41%) were placed with AIS catheters. Twenty-five patients (12%) with non-AIS catheters experienced shunt infection, whereas only two patients (1.4%) with AIS catheters had a shunt infection within the 6-month follow-up period (p < 0.01). Among infected patients, infected patients with standard shunt components had a longer average hospital stay, more inpatient complications related to infection treatment, and more multiple organism infections and multiple antibiotic regimens, compared with those with AIS components. Conclusions Although individual AIS components are more expensive than standard ones, factors contributing to medical costs are fewer in pediatric patients with infected shunts when the components are antibiotic-impregnated rather than standard.

scholarly journals Complications, Not Minimally Invasive Surgical Technique, Are Associated with Increased Cost after Esophagectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Sue J. Fu ◽  
Vanessa P. Ho ◽  
Jennifer Ginsberg ◽  
Yaron Perry ◽  
Conor P. Delaney ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Hospital Cost ◽  
Minimally Invasive Esophagectomy ◽  
Multivariable Analysis ◽  
Hospital Costs ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Invasive Esophagectomy ◽  
The Impact

Background. Minimally invasive esophagectomy (MIE) techniques offer similar oncological and surgical outcomes to open methods. The effects of MIE on hospital costs are not well documented. Methods. We reviewed the electronic records of patients who underwent esophagectomy at a single academic institution between January 2012 and December 2014. Esophagectomy techniques were grouped into open, hybrid, MIE, and transhiatal (THE) esophagectomy. Univariate and multivariate analyses were performed to assess the impact of surgery on total hospital cost after esophagectomy. Results. 80 patients were identified: 11 THE, 11 open, 41 hybrid, and 17 MIE. Median total cost of the hospitalization was $31,375 and was similar between surgical technique groups. MIE was associated with higher intraoperative costs, but not total hospital cost. Multivariable analysis revealed that the presence of a complication, increased age, American Society of Anesthesiologists class IV (ASA4), and preoperative coronary artery disease (CAD) were associated with significantly increased cost. Conclusions. Despite the association of MIE with higher operation costs, the total hospital cost was not different between surgical technique groups. Postoperative complications and severe preoperative comorbidities are significant drivers of hospital cost associated with esophagectomy. Surgeons should choose technique based on clinical factors, rather than cost implications.

scholarly journals INA-CBGs claim versus total hospital cost: A vaginal delivery investigation at Airlangga University Academic Hospital, Indonesia

2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Manggala Pasca Wardhana ◽  
Khanisyah Erza Gumilar ◽  
Prima Rahmadhany ◽  
Erni Rosita Dewi ◽  
Muhammad Ardian Cahya Laksana
Keyword(s):  
Vaginal Delivery ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Total Hospital Cost ◽  
Academic Hospital ◽  
Total Hospital ◽  
Cross Sectional ◽  
Level Ii

Background: Inadequate funding for vaginal delivery can be one of the barriers to reducing the maternal mortality rate. It could be therefore critical to compare the vaginal delivery cost between total hospital cost and INA-CBGs cost in national health insurance. Methods: This was a retrospective cross-sectional study conducted from October to December 2019 in Universitas Airlangga Academic Hospital. It collected data on primary diagnosis, length of stay, total hospital cost, INA-CBGs cost, and counted disparity. The data analyzed statistically using t-test independent sample (or Mann-Whitney test).Results: A total of 149 vaginal delivery claims were found, with the majority having a level II severity (79.87%) and moderate preeclampsia as a primary diagnosis (20.1%). There was a significant disparity in higher total hospital costs compared with government INA-CBGs costs (Rp. 9,238,022.09±1,265,801.88 vs 1,881,521.48±12,830.15; p<0.001). There was also an increase of LOS (p<0.001), total hospital cost (p<0.001), and cost disparity (p<0.01) in a higher severity level of vaginal delivery.Conclusion: Vaginal delivery costs in INA-CBGs scheme are underneath the actuarial value. There was also an increase in total hospital costs and a more significant disparity in the higher severity levels of vaginal delivery.

scholarly journals Intraventricular Vancomycin In Pediatric Patients With Cerebrospinal Fluid Shunt Infections

2004 ◽  
Vol 9 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Majed Al-Jeraisy ◽  
Stephanie J. Phelps ◽  
Michael L. Christensen ◽  
Stephanie Einhaus
Keyword(s):  
Cerebrospinal Fluid ◽  
Pediatric Patients ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Older Children ◽  
Vancomycin Concentration ◽  
Patients Âgés ◽  
Vancomycin Trough ◽  
Serum Vancomycin ◽  
Shunt Infections

OBJECTIVES To determine: 1) the range and magnitude of vancomycin trough cerebrospinal fluid (CSF) concentrations following intraventricular (IVT) vancomycin; 2) any correlation between patient demographic and CSF vancomycin concentrations; and 3) eradication and complications rates following IVT vancomycin. METHODS Medical records of pediatric patients with shunt infection who received IVT vancomycin during a 12 month period were reviewed. Demographic, microbiological data, IVT/intravenous (IV) vancomycin dosing, concomitant antibiotics, CSF and serum vancomycin concentrations, and CSF drainage output were recorded. RESULTS Seventeen patients ages 4 months to 17 years were hospitalized for shunt infection. Staphylococcus epidermidis (n=12) was the predominant organism. Sixteen patients received 10 mg, and one patient received 5 mg of IVT vancomycin for 3–23 days. All but one received concurrent IV vancomycin. The mean maximum trough CSF vancomycin concentration noted for 16 patients who recieved 10 mg of IVT vancomycin was 18.4±21.8 μg/mL (range: between 0.4 to 187.3 μg/mL). All four adolescents ≥25 kg had CSF vancomycin concentrations ≤5 μg/mL, three of four infants/children between 10.1 and 24.9 kg had trough CSF vancomycin concentrations between 10–20 μg/mL, and five of nine infants &lt;10 kg had CSF concentrations &gt;20 μg/mL. All organisms were successfully eradicated. One patient developed chronic eosinophilia presumed related to elevated CSF vancomycin concentrations (187 μg/mL). CONCLUSIONS –The combination of IVT and IV vancomycin effectively eradicated CSF shunt infections. CSF vancomycin concentrations are highly variable and poorly correlated with age and CSF output. Following a 10 mg IVT vancomycin dose, CSF concentrations appear to be lower in older children and elevated in infants/young children. One infant experienced a complication related to an elevated CSF vancomycin concentration; hence, therapy must be individualized, using CSF trough vancomycin concentrations.

scholarly journals Attributable Hospital Cost and Length of Stay Associated with Health Care-Associated Infections Caused by Antibiotic-Resistant Gram-Negative Bacteria

2009 ◽  
Vol 54 (1) ◽  
pp. 109-115 ◽  
Author(s):  
Patrick D. Mauldin ◽  
Cassandra D. Salgado ◽  
Ida Solhøj Hansen ◽  
Darshana T. Durup ◽  
John A. Bosso
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Confidence Interval ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Health Care Associated Infections

ABSTRACT Determination of the attributable hospital cost and length of stay (LOS) are of critical importance for patients, providers, and payers who must make rational and informed decisions about patient care and the allocation of resources. The objective of the present study was to determine the additional total hospital cost and LOS attributable to health care-associated infections (HAIs) caused by antibiotic-resistant, gram-negative (GN) pathogens. A single-center, retrospective, observational comparative cohort study was performed. The study involved 662 patients admitted from 2000 to 2008 who developed HAIs caused by one of following pathogens: Acinetobacter spp., Enterobacter spp., Escherichia coli, Klebsiella spp., or Pseudomonas spp. The attributable total hospital cost and LOS for HAIs caused by antibiotic-resistant GN pathogens were determined by comparison with the hospital costs and LOS for a control group with HAIs due to antibiotic-susceptible GN pathogens. Statistical analyses were conducted by using univariate and multivariate analyses. Twenty-nine percent of the HAIs were caused by resistant GN pathogens, and almost 16% involved a multidrug-resistant GN pathogen. The additional total hospital cost and LOS attributable to antibiotic-resistant HAIs caused by GN pathogens were 29.3% (P < 0.0001; 95% confidence interval, 16.23 to 42.35) and 23.8% (P = 0.0003; 95% confidence interval, 11.01 to 36.56) higher than those attributable to HAIs caused by antibiotic-susceptible GN pathogens, respectively. Significant covariates in the multivariate analysis were age ≥12 years, pneumonia, intensive care unit stay, and neutropenia. HAIs caused by antibiotic-resistant GN pathogens were associated with significantly higher total hospital costs and increased LOSs compared to those caused by their susceptible counterparts. This information should be used to assess the potential cost-efficacy of interventions aimed at the prevention of such infections.

scholarly journals Perioperative Cumulative Fluid Balance and Its Association with an Increase in Costs after Major Surgery

2018 ◽  
Vol 7 (9) ◽  
pp. 227
Author(s):  
Tak Oh ◽  
Jung-Won Hwang ◽  
Young-Tae Jeon ◽  
Sang-Hwan Do
Keyword(s):  
Fluid Balance ◽  
Medical Records ◽  
Hospital Costs ◽  
Perioperative Period ◽  
Major Surgery ◽  
Total Hospital Cost ◽  
Total Hospital ◽  
Total Input ◽  
Estimated Blood Loss ◽  
Cumulative Fluid Balance

Positive fluid balance (FB) during the perioperative period may increase the incidence of postoperative complications, which may lead to longer hospitalization and higher hospital costs. However, a definitive association between positive FB and hospital costs has not yet been established. This retrospective observational study examined the association between perioperative FB and hospital costs of patients who underwent major surgical procedures. Medical records of patients who underwent major surgery (surgery time >2 h, estimated blood loss >500 mL) from January 2010 to December 2017 were analyzed to determine the associations between calculated FB (%, total input fluid—output fluid in liter/weight (kg) at admission) and total hospital cost ($). The analysis included medical data of 7010 patients. Multivariable linear regression analyses showed that a 1% increase in FB in postoperative day (POD) 0 (24 h), 0–1 (48 h), 0–2 (72 h), and 0–3 (96 h) significantly increased the total cost by $967.8 (95% confidence interval [CI]: 803.4–1132.1), $688.8 (95% CI: 566.3–811.2), $591 (95% CI: 485.7–696.4), and $434.2 (95% CI: 349.4–519.1), respectively (all p < 0.001). Perioperative cumulative FB was positively associated with hospital costs of patients who underwent major surgery.

Multidisciplinary approach to cerebrospinal fluid shunt infection with an appeal for attention to details in assessment and standardization in reporting

2011 ◽  
Vol 7 (5) ◽  
pp. 452-461 ◽  
Author(s):  
Ken R. Winston ◽  
Susan A. Dolan
Keyword(s):  
At Risk ◽  
Multidisciplinary Approach ◽  
Shunt Infection ◽  
Csf Shunt ◽  
Accurate Identification ◽  
Meaningful Information ◽  
Valid Data ◽  
Csf Shunt Infection ◽  
Criteria For Diagnosis ◽  
Shunt Infections

Object The goal of this study was to evaluate the problems encountered in monitoring CSF shunt infection, including the collection, analysis, and reporting of data. The authors propose a system that would produce more accurate, and hence more meaningful, information on shunt infection than do the methodologies and customs now in common use. Methods The authors reviewed and analyzed 19 years of quarterly records of a committee that has addressed CSF shunt infection in an ongoing manner. Results There are strong incentives, political and otherwise, to identify low rates of CSF shunt infection. Details of the composition and operation of a multidisciplinary approach to CSF shunt infection are summarized. Many factors affect the occurrence of shunt infection and its accurate assessment and reporting. Easily accessible sources for the identification of cases of shunt infections and for the assessment of an at-risk population often contain discrepancies in significant numbers. Conclusions Multidisciplinary oversight of the entire matter of CSF shunt infection enhances the chances for collecting accurate data, identifying causes of infection, and developing effective preventative strategies. Valid data require a mechanism for finding all individuals within the at-risk pool; the accurate identification of patients who had shunt infections; standard, pragmatic, and robust criteria for diagnosis of shunt infection; and multidisciplinary oversight of the entire process.

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