ArticleActa neurochirurgica2025
Age at time of surgery does not influence outcome in idiopathic normal pressure hydrocephalus - a national quality registry study of 3082 patients.
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aims to investigate the outcome of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH) in relation to age at surgery, using data from the Swedish Hydrocephalus Quality Registry (SHQR). The disease affects older patients, with a mean age at diagnosis of 74 years. Since shunt surgery, which introduces a risk of serious complications, is the only available treatment, appropriate selection of patients eligible for surgery is essential. It has been suggested that higher age negatively affects outcome after shunt surgery.
methodsPatients operated upon during January 2004-February 2022 were included. The inclusion criteria were: age ≥ 60 years and data available from ≥ 3 domains by the iNPH scale. Clinical outcomes were assessed at 3 and 12 months using the modified version of the iNPH scale (miNPH), the Timed Up-and-Go (TUG) test and the modified Rankin scale (mRS). These were related to 5-year-interval age groups.
resultsImprovement was seen in all age groups, with no statistically significant differences in outcome between age groups in miNPH score, TUG or mRS. The oldest group (> 85 years) showed significant improvements, as illustrated by miNPH scale score changes at 3 and 12 months of 4.3 (-8.1 to 21.5) and 10.1 (-6.5 to 36.8), respectively.
conclusionsThis population-based study shows similarly favourable outcomes across ages, suggesting that there should be no upper age limit for shunt surgery in patients with iNPH.
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