Early Clinical Outcomes of Congenital Encephalocele and Mortality Risk Factors: A Tertiary Center Experience

Year 2024, Volume: 1 Issue: 2, 124 - 130, 14.06.2024

Akan Yaman İbrahim Kandemir

Abstract

Objective: To investigate the early clinical outcomes of infants with congenital encephalocele
Methods: We investigated newborns diagnosed with congenital encephalocele and treated in our hospital. We recorded data of the patients regarding the delivery history, anthropometric features, and clinical outcomes. We used conventional statistical methods and Bayesian models.
Results: We included 18 patients (%61.1 female, 38.9% male) in the study. The median birth week was 38 (36.3-39) weeks, and the mean birth weight was 2837+/-816 grams. 83.3% of the patients had undergone an operation with a median of 5 days. The defect diameter was more than 5 cm in 61.1% of the patients, and brain parenchyma was positive in the sac in half of the patients. 22.2% of the patients needed ventriculoperitoneal shunt insertion. The overall survival resulted in 61.1% in all patients and 73.3% in operated. There were statistically significant differences in terms of birth weight (p<0.001, 3150 v.s 2470 grams) and birth week (38.6 v.s 34.6 weeks, p=0.021), as deceased patients had lower birth weight and birth week.
In Bayesian Kendall’s tau calculations, Neural tissue involvement, defect diameter more than 5 cm, birth weight (very strong evidence), operation within three days of life and birth week (strong evidence), and shunt need and seizures (moderate evidence) had an impact on mortality. There was no significant risk factor for hydrocephalus development, but there was a correlation between hydrocephalus and shunt need. Also, Dandy walker deformity correlated with shunt need (moderate evidence), but the birth week and neural tissue involvement were independent of shunt need (moderate evidence).
Conclusion: The poor prognostic factors for mortality were defect diameter larger than 5 cm, neural tissue involvement in the sac, lower birth week, lower birth weight, and seizures, and the good prognostic factor was operation before postnatal three days of life.

Keywords

Congenital encephalocele, Infant, Newborn

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