Affordable Access

Access to the full text

Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study

Authors
  • Andrén, Kerstin1
  • Wikkelsö, Carsten1
  • Sundström, Nina2
  • Agerskov, Simon1
  • Israelsson, Hanna3
  • Laurell, Katarina3
  • Hellström, Per1
  • Tullberg, Mats1
  • 1 The Sahlgrenska Academy, University of Gothenburg, Hydrocephalus Research Unit, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Blå Stråket 7, Gothenburg, 413 45, Sweden , Gothenburg (Sweden)
  • 2 Umeå University, Department of Radiation Sciences, Biomedical Engineering, R&D, Umeå, 901 85, Sweden , Umeå (Sweden)
  • 3 Umeå University, Department of Pharmacology and Clinical Neuroscience, Umeå, 901 87, Sweden , Umeå (Sweden)
Type
Published Article
Journal
Journal of Neurology
Publisher
Springer-Verlag
Publication Date
Nov 29, 2017
Volume
265
Issue
1
Pages
178–186
Identifiers
DOI: 10.1007/s00415-017-8680-z
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThere is little knowledge about the factors influencing the long-term outcome after surgery for idiopathic normal pressure hydrocephalus (iNPH).ObjectiveTo evaluate the effects of reoperation due to complications and of vascular comorbidity (hypertension, diabetes, stroke and heart disease) on the outcome in iNPH patients, 2–6 years after shunt surgery.MethodsWe included 979 patients from the Swedish Hydrocephalus Quality Registry (SHQR), operated on for iNPH during 2004–2011. The patients were followed yearly by mailed questionnaires, including a self-assessed modified Rankin Scale (smRS) and a subjective comparison between their present and their preoperative health condition. The replies were grouped according to the length of follow-up after surgery. Data on clinical evaluations, vascular comorbidity, and reoperations were extracted from the SHQR.ResultsOn the smRS, 40% (38–41) of the patients were improved 2–6 years after surgery and around 60% reported their general health condition to be better than preoperatively. Reoperation did not influence the outcome after 2–6 years. The presence of vascular comorbidity had no negative impact on the outcome after 2–6 years, assessed as improvement on the smRS or subjective improvement of the health condition, except after 6 years when patients with hypertension and a history of stroke showed a less favorable development on the smRS.ConclusionThis registry-based study shows no negative impact of complications and only minor effects of vascular comorbidity on the long-term outcome in iNPH.

Report this publication

Statistics

Seen <100 times