Title |
Shunt Intervention for Possible Idiopathic Normal Pressure Hydrocephalus Improves Patient Outcomes: A Nationwide Hospital-Based Survey in Japan
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Published in |
Frontiers in Neurology, June 2018
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DOI | 10.3389/fneur.2018.00421 |
Pubmed ID | |
Authors |
Madoka Nakajima, Masakazu Miyajima, Ikuko Ogino, Chihiro Akiba, Kaito Kawamura, Michiko Kurosawa, Nagato Kuriyama, Yoshiyuki Watanabe, Wakaba Fukushima, Etsuro Mori, Takeo Kato, Hidenori Sugano, Kostadin Karagiozov, Hajime Arai |
Abstract |
Background and Purpose: This study aimed to investigate the efficacy of cerebrospinal fluid shunt intervention for idiopathic normal pressure hydrocephalus (iNPH) using data from a nationwide epidemiological survey in Japan. Methods: We conducted a cross-sectional study using data from a nationwide epidemiological survey performed in Japan. Propensity score matching was used to select 874 patients from 1,423 patients aged ≥60 years, who were diagnosed with iNPH based on clinical guidelines following a hospital visit in 2012. Patients who experienced an improvement of at least 1 modified Rankin Scale (mRS) grade after the intervention were classified as "improved," while the remaining patients were classified as "non-improved." In the shunt intervention (n = 437) and non-shunt intervention (n = 437) groups, the differences in mRS grade improvement were analyzed using the Mann-Whitney U-test. Finally, we examined subjects in the shunt intervention group (n = 974) to compare the outcomes and complications of ventriculoperitoneal (VP) shunt (n = 417) with lumboperitoneal (LP) shunt (n = 540). Results: We examined subjects with iNPH to compare the non-shunt intervention group to the shunt intervention group following adjustment for age and mRS grade at baseline by propensity score matching (0.31-0.901). The mRS grade (mean [SD]) was found to improve with non-shunt intervention (2.46 [0.88]) and shunt intervention (1.93 [0.93]) (p < 0.001) in iNPH patients. The mRS outcome score and complications comparison between the VP and LP shunt groups did not show significant difference. Conclusions: In this study, analysis of the efficacy of shunts for possible iNPH conducted in Japan indicated a significant improvement in the mRS grade between baseline and outcome within 1 year, regardless of the surgical technique, and shunt intervention was found to be effective. |
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Geographical breakdown
Country | Count | As % |
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Japan | 1 | 33% |
Unknown | 2 | 67% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 3 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 40 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Professor > Associate Professor | 7 | 18% |
Student > Bachelor | 7 | 18% |
Other | 4 | 10% |
Researcher | 3 | 8% |
Professor | 2 | 5% |
Other | 6 | 15% |
Unknown | 11 | 28% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 30% |
Neuroscience | 8 | 20% |
Nursing and Health Professions | 4 | 10% |
Chemical Engineering | 1 | 3% |
Social Sciences | 1 | 3% |
Other | 1 | 3% |
Unknown | 13 | 33% |