Table 2.
Mechanisms of death among people with myelomeningocele with or without shunted hydrocephalus (p= 0.003)
| Mechanism of death | Shunted | Unshunted | Overall |
| (n = 261) | (n = 32) | (n = 293) | |
| Infections | 90 (34%) | 12 (38%) | 102 (35%) |
| Pneumonia (aspiration) | 29 (13) | 6 (3) | 35 (16) |
| Urosepsis | 15 | 1 | 16 |
| Skin ulcer or wound | 13 | 0 | 13 |
| Peritonitis, no bladder perforation | 12 | 1 | 13 |
| Peritonitis, bladder perforation | 1 | 0 | 1 |
| Shunt infection | 11 | 0 | 11 |
| Encephalitis | 0 | 1 | 1 |
| Endocarditis | 1 | 0 | 1 |
| Venous access device | 1 | 0 | 1 |
| Unknown source | 7 | 3 | 10 |
| Non-infectious shunt malfunction | 37 (14%) | 0 (0%) | 37 (13%) |
| Chiari II malformation | 0 (0%) | 1 (3%) | 1 (0.3%) |
| Non-infectious pulmonary disease | 15 (6%) | 5 (16%) | 20 (7%) |
| Cardiovascular disease (congenital) | 0 (0.0%) | 1 (3%) | 1 (0.3%) |
| Cardiovascular disease (non-congenital) | 10 (4%) | 3 (9%) | 13 (4%) |
| Pulmonary embolus | 4 | 0 | 4 |
| Cerebrovascular accident | 3 | 0 | 3 |
| Intracranial hemorrhage | 1 | 1 | 2 |
| Other | 2* | 2** | 4 |
| Renal failure | 7 (3%) | 2 (6%) | 9 (3%) |
| Exsanguination from gross hematuria | 1 (0.3%) | 0 (0%) | 1 (0.3%) |
| Seizure-related | 7 (3%) | 0 (0%) | 7 (2%) |
| Status epilepticus | 4 | 0 | 4 |
| Other seizure-related cause | 2 | 0 | 2 |
| Sudden unexpected death in epilepsy (SUDEP) | 1 | 0 | 1 |
| Trauma | 7 (3%) | 0 (0%) | 7 (2%) |
| Accidental | 6 | 0 | 6 |
| Non-accidental (suicide) | 1 | 0 | 1 |
| Non-infectious gastrointestinal | 6 (2%) | 0 (0%) | 6 (2%) |
| Ischemic bowel | 4 | 0 | 4 |
| Other (small bowel obstruction, gastrointestinal bleeding) | 2 | 0 | 2 |
| Cancer | 4 (2%) | 1 (3%) | 5 (2%) |
| Hematogenous cancer | 2*** | 1**** | 3 |
| Transitional cell carcinoma of the bladder | 1 | 0 | 1 |
| Colon cancer | 1 | 0 | 1 |
| Complication of pregnancy | 1 (0.3%) | 0 (0%) | 1 (0.3%) |
| Multi-drug toxicity | 1 (0.3%) | 0 (0%) | 1 (0.3%) |
| Drug overdose (opioid) | 0 (0%) | 1 (3%) | 1 (0.3%) |
| Neonatal mortality (multi-system) | 3 (1%) | 1 (3%) | 4 (1%) |
| Unknown cause of death | 72 (28%) | 5 (16%) | 77 (26%) |
| Unexplained deaths (unexpected deaths while asleep, without attributable known cause) | 11 | 2 | 13 |
| Other unknown (including ‘spina bifida’ and ‘multiple congenital anomalies’) | 61 | 3 | 64 |
*Congestive heart failure, myocardial infarction. **Cardiac arrest, portal vein thrombosis. ***Acute lymphoblastic leukemia, lymphoblastic t-cell lymphoma. ****Myelodysplastic syndrome. Totals may not add up to 100% due to rounding.