Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery

Objective: To evaluate the outcomes and prognostic factors of ventriculoperitoneal shunts (VP-shunts) in patients with idiopathic normal-pressure hydrocephalus (iNPH) at 6 months and 2 years after surgery.Method: We retrospectively analyzed 68 patients admitted to our institute and diagnosed with pr...

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Autores principales:	Abdul Malik Popal, Zhoule Zhu, Xinxia Guo, Zhe Zheng, Chengwei Cai, Hongjie Jiang, Jianmin Zhang, Anwen Shao, Junming Zhu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	outcome comorbidities prognostic factor ventriculoperitoneal shunt normal-pressure hydrocephalus Surgery RD1-811
Acceso en línea:	https://doaj.org/article/857236281025491a8248adf11cf9ca76
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spelling	oai:doaj.org-article:857236281025491a8248adf11cf9ca762021-11-15T05:04:00ZOutcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery2296-875X10.3389/fsurg.2021.641561https://doaj.org/article/857236281025491a8248adf11cf9ca762021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.641561/fullhttps://doaj.org/toc/2296-875XObjective: To evaluate the outcomes and prognostic factors of ventriculoperitoneal shunts (VP-shunts) in patients with idiopathic normal-pressure hydrocephalus (iNPH) at 6 months and 2 years after surgery.Method: We retrospectively analyzed 68 patients admitted to our institute and diagnosed with probable iNPH from January 2017 to March 2021. All patients underwent VP-shunt surgery with a programmable valve, and their outcomes were assessed via the Krauss index and modified Rankin scale (mRS) at 6 months and 2 years post-surgery. Univariate and multivariate regression analysis was performed to identify the prognostic factors.Results: The mean age of the patients was 71.1 ± 8.4 (mean ± standard deviation) years. On the Krauss improvement index, 6-month follow-up results were available for 68 patients. Of these patients, 91.2% experienced attenuation of their preoperative symptoms, with a mean Krauss index of 0.58 ± 0.27, and 48 patients (70.6%) had a Krauss index ≥0.5. Two-year follow-up results were available for 33 patients; 90.9% of them had sustained improvement, with a Krauss index of 0.54 ± 0.31, and 21 patients (66.3%) had a Krauss index ≥0.5. Thirty-three patients (58%) were living independently after 2 years (mRS 0–2). The outcomes were worse for patients with multiple comorbidities. Neither an increased patient age nor a prolonged history of illness was statistically significant prognostic factors for adverse outcomes of VP-shunt surgery.Conclusion: Surgical treatment was well-tolerated by patients with iNPH who received VP-shunts. Most patients experienced attenuation of their preoperative symptoms. Multiple concurrent comorbidities should be considered as adverse prognostic factors before shunt insertion in patients with iNPH.Abdul Malik PopalZhoule ZhuXinxia GuoZhe ZhengChengwei CaiHongjie JiangJianmin ZhangAnwen ShaoJunming ZhuFrontiers Media S.A.articleoutcomecomorbiditiesprognostic factorventriculoperitoneal shuntnormal-pressure hydrocephalusSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	outcome comorbidities prognostic factor ventriculoperitoneal shunt normal-pressure hydrocephalus Surgery RD1-811
spellingShingle	outcome comorbidities prognostic factor ventriculoperitoneal shunt normal-pressure hydrocephalus Surgery RD1-811 Abdul Malik Popal Zhoule Zhu Xinxia Guo Zhe Zheng Chengwei Cai Hongjie Jiang Jianmin Zhang Anwen Shao Junming Zhu Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
description	Objective: To evaluate the outcomes and prognostic factors of ventriculoperitoneal shunts (VP-shunts) in patients with idiopathic normal-pressure hydrocephalus (iNPH) at 6 months and 2 years after surgery.Method: We retrospectively analyzed 68 patients admitted to our institute and diagnosed with probable iNPH from January 2017 to March 2021. All patients underwent VP-shunt surgery with a programmable valve, and their outcomes were assessed via the Krauss index and modified Rankin scale (mRS) at 6 months and 2 years post-surgery. Univariate and multivariate regression analysis was performed to identify the prognostic factors.Results: The mean age of the patients was 71.1 ± 8.4 (mean ± standard deviation) years. On the Krauss improvement index, 6-month follow-up results were available for 68 patients. Of these patients, 91.2% experienced attenuation of their preoperative symptoms, with a mean Krauss index of 0.58 ± 0.27, and 48 patients (70.6%) had a Krauss index ≥0.5. Two-year follow-up results were available for 33 patients; 90.9% of them had sustained improvement, with a Krauss index of 0.54 ± 0.31, and 21 patients (66.3%) had a Krauss index ≥0.5. Thirty-three patients (58%) were living independently after 2 years (mRS 0–2). The outcomes were worse for patients with multiple comorbidities. Neither an increased patient age nor a prolonged history of illness was statistically significant prognostic factors for adverse outcomes of VP-shunt surgery.Conclusion: Surgical treatment was well-tolerated by patients with iNPH who received VP-shunts. Most patients experienced attenuation of their preoperative symptoms. Multiple concurrent comorbidities should be considered as adverse prognostic factors before shunt insertion in patients with iNPH.
format	article
author	Abdul Malik Popal Zhoule Zhu Xinxia Guo Zhe Zheng Chengwei Cai Hongjie Jiang Jianmin Zhang Anwen Shao Junming Zhu
author_facet	Abdul Malik Popal Zhoule Zhu Xinxia Guo Zhe Zheng Chengwei Cai Hongjie Jiang Jianmin Zhang Anwen Shao Junming Zhu
author_sort	Abdul Malik Popal
title	Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
title_short	Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
title_full	Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
title_fullStr	Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
title_full_unstemmed	Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery
title_sort	outcomes of ventriculoperitoneal shunt in patients with idiopathic normal-pressure hydrocephalus 2 years after surgery
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/857236281025491a8248adf11cf9ca76
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Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery

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