論文

査読有り 国際誌
2019年

Background Risk Factors Associated with Shunt Intervention for Possible Idiopathic Normal Pressure Hydrocephalus: A Nationwide Hospital-Based Survey in Japan.

Journal of Alzheimer's disease : JAD
  • Madoka Nakajima
  • Nagato Kuriyama
  • Masakazu Miyajima
  • Ikuko Ogino
  • Chihiro Akiba
  • Kaito Kawamura
  • Michiko Kurosawa
  • Yoshiyuki Watanabe
  • Wakaba Fukushima
  • Etsuro Mori
  • Takeo Kato
  • Hidenori Sugano
  • Yuichi Tange
  • Kostadin Karagiozov
  • Hajime Arai
  • 全て表示

68
2
開始ページ
735
終了ページ
744
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.3233/JAD-180955

BACKGROUND: Patients with idiopathic normal-pressure hydrocephalus (iNPH) are typically older adults with multiple comorbidities that are associated with a reduction in the efficacy of iNPH treatment via cerebrospinal fluid (CSF) shunt placement. OBJECTIVE: The present study aimed to investigate the effectiveness of CSF shunt for iNPH using data from a nationwide epidemiological survey in Japan. METHODS: We examined 1,423 patients (581 women) aged ≥60 years (median age [25%-75%]: 77 [73-80] years) who were diagnosed with iNPH following a hospital visit in 2012. Patients who experienced an improvement of at least one modified Rankin Scale (mRS) grade after the CSF shunt were classified as "improvement" while the remaining patients were classified as "non-improvement." The efficacy of the shunt intervention (n = 842) was analyzed using a binomial logistic regression analysis. RESULTS: An analysis of risk factors associated with shunt placement in patients with mRS grade 2 revealed an association between comorbid chronic ischemic lesions (odds ratio [OR], 2.28; 95% confidence interval [CI], 1.11-4.67; p = 0.025) and cervical spondylosis (OR, 3.62; 95% CI, 1.15-11.34; p = 0.027). Patients with mRS grade 3 at study entry had an association with comorbid Alzheimer's disease (OR, 3.02; 95% CI, 1.44-6.31; p = 0.003). CONCLUSIONS: The results presented here showed that any age-related risk is minimal and should not be cause for rejection of surgical treatment options. Clinical decisions regarding CSF shunt should be individualized to each patient, with adequate consideration of the relative risks and benefits, including maximizing a healthy life expectancy.

リンク情報
DOI
https://doi.org/10.3233/JAD-180955
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30883349
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6484254
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000462875000028&DestApp=WOS_CPL
ID情報
  • DOI : 10.3233/JAD-180955
  • ISSN : 1387-2877
  • PubMed ID : 30883349
  • PubMed Central 記事ID : PMC6484254
  • Web of Science ID : WOS:000462875000028

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