5-Year health-related quality of life outcome in patients with idiopathic normal pressure hydrocephalus
Open Access
- 2 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Zeitschrift für Neurologie
- Vol. 268 (9), 3283-3293
- https://doi.org/10.1007/s00415-021-10477-x
Abstract
Background Health-related quality of life (HRQoL) is severely impaired in persons with idiopathic normal pressure hydrocephalus (iNPH). The HRQoL improves in a number of patients after the placement of a cerebrospinal fluid (CSF) shunt, but long-term follow-up of HRQoL is rare. Methods Extended follow-up (60 months) of a prospective cohort study involving 189 patients with iNPH who underwent shunt surgery. Preoperative variables were used to predict favorable HRQoL outcome (improvement or non-deterioration) measured by the 15D instrument 5 years after shunting. Results Out of the 189 initially enrolled study participants, 88 had completed 5-year HRQoL follow-up (46%), 64 had died (34%), and 37 (20%) failed to complete the HRQoL follow-up but were alive at the end of the study. After initial post-operative HRQoL improvement, HRQoL deteriorated so that 37/88 participants (42%) had a favorable HRQoL outcome 5 years after shunting. Multivariate binary logistic regression analysis indicated that younger age (adjusted OR 0.86, 95% CI 0.77–0.95; p < 0.005), lower body mass index (adjusted OR 0.87, 95% CI 0.77–0.98; p < 0.05) and better Mini-Mental State Examination performance (adjusted OR 1.16, 95% CI 1.01–1.32; p < 0.05) before surgery predicted favorable 5-year outcome. Conclusions This extended follow-up showed that the self-evaluated HRQoL outcome is associated with iNPH patients’ pre-operative cognitive status, overweight and age. The post-operative deterioration may reflect the natural progression of iNPH, but also derive from aging and comorbidities. It indicates a need for long-term follow-up.Keywords
Funding Information
- Kuopion Yliopistollinen Sairaala
- Sigrid Juséliuksen Säätiö
- State Research Funding
- Suomen Lääketieteen Säätiö
- University of Eastern Finland (UEF) including Kuopio University Hospital
This publication has 26 references indexed in Scilit:
- Predictors of Subsequent Overdrainage and Clinical Outcomes After Ventriculoperitoneal Shunting for Idiopathic Normal Pressure HydrocephalusNeurosurgery, 2013
- Indications for valve-pressure adjustments of gravitational assisted valves in patients with idiopathic normal pressure hydrocephalusSurgical Neurology International, 2013
- CSF biomarkers for Alzheimer disease correlate with cortical brain biopsy findingsNeurology, 2012
- Cortical Brain Biopsy in Long-Term Prognostication of 468 Patients with Possible Normal Pressure HydrocephalusNeurodegenerative Diseases, 2012
- Postshunt Cognitive and Functional Improvement in Idiopathic Normal Pressure HydrocephalusNeurosurgery, 2011
- What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementiaInternational Journal of Geriatric Psychiatry, 2008
- Validation of Grading Scale for Evaluating Symptoms of Idiopathic Normal-Pressure HydrocephalusDementia and Geriatric Cognitive Disorders, 2007
- Validation of a combined comorbidity indexJournal of Clinical Epidemiology, 1994
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975
- An Inventory for Measuring DepressionArchives of General Psychiatry, 1961