Twelve-Year Hospital Outcomes in Patients with Idiopathic Hydrocephalus

Abstract

Objective: The aim of this study was to examine patients who were admitted for the first-ever shunting for idiopathic normal pressure hydrocephalus (INPH) during a 12-year period, in terms of variation rate, patient demographic characteristics, shunt procedures, postoperative complications, and hospital outcome.

Methods: An electronic database which included all shunted patients (1998 to 2009) was used to retrieve demographic, clinical, and hospital outcome data. INPH patient identification was based on clinical and imaging diagnostic criteria.

Results: INPH patients (n = 238) who had undergone shunting were identified. The mean age and male to female ratio of INPH patients were 73.3 (± 7) years and 1.28:1, respectively.

The number of surgically managed INPH cases and proportion of INPH-related shunting procedures rose consecutively during the second and last third of the study period. Ventriculoperitoneal shunts (n = 129; 54.2%) were the most commonly used configurations, followed by ventriculoatrial (n = 108; 45.4%) and lumboperitoneal (n = 1; 0.4%). Intrahospital shunt-related complications were hematomas (0.84%), meningitis (0.42%), and status epilepticus (0.42%). A favorable outcome was reported for 66.8% of patients; 31.5% showed no change. Overall inpatient mortality was 1.7%.

Conclusion: The quantitative findings indicate a progressive rise in the number of surgically managed INPH patients that parallels a rise in the proportion of INPH-related shunting procedures. Contributing factors are likely to include improved diagnosis and an increase in awareness of the INPH syndrome by referring physicians.