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Waiting time for surgery influences the outcome in idiopathic normal pressure hydrocephalus: a population-based study
Örebro University, School of Medical Sciences. Department of Medical Sciences.
Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden.
Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Department of Clinical Neuroscience Karolinska Institutet, Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.
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2022 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 164, no 2, p. 469-478Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Idiopathic normal pressure hydrocephalus (iNPH) is a disease that comes with a great impact on the patient's life. The only treatment for iNPH, which is a progressive disease, is shunt surgery. It is previously indicated that early intervention might be of importance for the outcome.

AIM: To investigate if a longer waiting time for surgery, negatively influences the clinical outcome.

METHODS: Eligible for this study were all iNPH patients (n = 3007) registered in the Swedish Hydrocephalus Quality Registry (SHQR) during 1st of January 2004-12th of June 2019. Waiting time, defined as time between the decision to accept a patient for surgery and shunt surgery, was divided into the intervals ≤ 3, 3.1-5.9 and ≥ 6 months. Clinical outcome was assessed 3 and 12 months after surgery using the modified iNPH scale, the Timed Up and Go (TUG) test and the mini mental state examination (MMSE).

RESULTS: Three months after surgery, 57% of the patients with ≤ 3 months waiting time showed an improvement in modified iNPH scale (≥ 5 points) whereas 52% and 46% of patients with 3.1-5.9 and ≥ 6 months waiting time respectively improved (p = 0.0115). At 12 months of follow-up, the corresponding numbers were 61%, 52% and 51% respectively (p = 0.0536).

CONCLUSIONS: This population-based study showed that in patients with iNPH, shunt surgery should be performed within 3 months of decision to surgery, to attain the best outcome.

Place, publisher, year, edition, pages
Springer, 2022. Vol. 164, no 2, p. 469-478
Keywords [en]
Idiopathic normal pressure hydrocephalus, Sex, Shunt surgery, Waiting time, iNPH scale
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-96290DOI: 10.1007/s00701-021-05085-7ISI: 000736500200002PubMedID: 34970701Scopus ID: 2-s2.0-85122147907OAI: oai:DiVA.org:oru-96290DiVA, id: diva2:1625465
Note

Funding agencies:

Örebro University

ALF (Agreement concerning research and education of doctors) funding Region Örebro County

Available from: 2022-01-07 Created: 2022-01-07 Last updated: 2022-03-09Bibliographically approved

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Chidiac, ChristineOlivecrona, Magnus

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