Causes of death among people with myelomeningocele: A multi-institutional 47-year retrospective study.
Konrad M Szymanski, Cyrus M Adams, Mohammad Y Alkawaldeh and 35 others
PMID 38073338WHAT IT FOUND
In 293 deaths among people with myelomeningocele, shunted patients most often died of neurological causes while unshunted patients died of pulmonary causes.
Infection was the leading mechanism overall, but a quarter of deaths had unknown causes, limiting clear prevention targets.
Key findings
01Neurological causes were the leading cause of death in shunted patients, whereas pulmonary causes were leading in unshunted patients.
02Infections were the most common mechanism of death across the entire cohort.
03Urological causes accounted for 10% of deaths, with urosepsis and renal failure being the most frequent specific causes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used a convenience sample from tertiary centers, likely overrepresenting patients with severe disease and multiple comorbidities compared to the general myelomeningocele population. A quarter of deaths had unknown causes, reducing the precision of the findings. The unshunted group was heterogeneous, mixing infants too ill for shunting with older individuals who did not need shunts, which complicates comparisons. Data were retrospective and relied on medical records and death certificates, which may be inaccurate or incomplete. The study only included people who died, so it cannot determine mortality risks or rates for living patients.
Declared interests
None declared.
The easy way to misread this
Do not interpret the low rate of unexplained deaths (4%) as evidence that sudden unexpected death is not a risk in other populations, as this study relied on retrospective classification and had a high rate of unknown causes (26%). Additionally, the finding that shunted patients died of neurological causes does not mean the shunt itself caused death; it likely marks more severe underlying neurological impairment.