Waiting time for surgery influences the outcome in idiopathic normal pressure hydrocephalus: a population-based studyShow others and affiliations
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
2022-01-072022-01-072022-03-09Bibliographically approved