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Incidence, Comorbid...
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Pyykko, Okko T.Kuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
(author)
Incidence, Comorbidities, and Mortality in Idiopathic Normal Pressure Hydrocephalus
- Article/chapterEnglish2018
Publisher, publication year, extent ...
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ELSEVIER SCIENCE INC,2018
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Numbers
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LIBRIS-ID:oai:DiVA.org:uu-356808
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-356808URI
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https://doi.org/10.1016/j.wneu.2018.01.107DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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OBJECT: To investigate the incidence, comorbidities, mortality, and causes of death in idiopathic normal pressure hydrocephalus (iNPH). METHODS: A cohort of 536 patients with possible NPH from a defined population with a median follow-up time of 5.1 years, (range 0.04-19.9 years) was included in the study. Patients were evaluated by brain imaging and intraventricular pressure monitoring, with a brain biopsy specimen immunostained against amyloid-beta and hyper-phosphorylated tau. Hospital records were reviewed for vascular diseases and type 2 diabetes mellitus (T2DM). Death certificates and yearly population of the catchment area were obtained from national registries. RESULTS: A total of 283 patients had a clinical diagnosis of iNPH, leading to a median annual incidence of 1.58 iNPH patients per 100,000 inhabitants (range, 0.8-4.5). Alzeimer disease-related brain biopsy findings were less frequent in iNPH patients than in non-iNPH patients (P < 0.05). An overrepresentation of hypertension (52% vs. 33%, P < 0.001) and T2DM (23% vs. 13%, P = 0.002) was noted in iNPH patients. Age (hazard ratio [HR] 1.04/year, 95% confidence interval [CI] 1.03-1.06, P< 0.001) and T2DM (HR 1.63, 95% CI 1.23-2.16, P < 0.001) increased the risk of death in the iNPH patients and in the total population. iNPH was associated with decreased risk of death (HR 0.63, 95% CI 0.50-0.78, P < 0.001). The most frequent causes of death were cardiovascular and cerebrovascular disease. Dementia as a cause of death was more common in non-iNPH patients (27% vs. 10%, P < 0.001). CONCLUSIONS: Hypertension and T2DM are common in iNPH and the latter causes excess mortality in the affected patients.
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Nerg, OssiKuopio Univ Hosp, Neurol NeuroCtr, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
(author)
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Niskasaari, Hanna-MariKuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
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Niskasaari, TimoKuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
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Koivisto, Anne M.Kuopio Univ Hosp, Neurol NeuroCtr, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
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Hiltunen, MikkoUniv Eastern Finland, Inst Biomed, Dept Neurol, Kuopio Univ Hosp, Kuopio, Finland
(author)
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Pihlajamaki, JussiUniv Eastern Finland, Inst Publ Hlth & Clin Nutr, Dept Clin Nutr, Kuopio, Finland;Kuopio Univ Hosp, Clin Nutr & Obes Ctr, Kuopio, Finland
(author)
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Rauramaa, TuomasKuopio Univ Hosp, Dept Pathol, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Pathol, Kuopio, Finland
(author)
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Kojoukhova, MariaKuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
(author)
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Alafuzoff, IrinaUppsala universitet,Klinisk och experimentell patologi,Irina Alafuzoff(Swepub:uu)irial548
(author)
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Soininen, HilkkaKuopio Univ Hosp, Neurol NeuroCtr, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
(author)
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Jaaskelainen, Juha E.Kuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
(author)
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Leinonen, VilleKuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, Finland
(author)
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Kuopio Univ Hosp, Neurosurg NeuroCtr, Kuopio, FinlandKuopio Univ Hosp, Neurol NeuroCtr, Kuopio, Finland;Univ Eastern Finland, Inst Clin Med Neurol, Kuopio, Finland
(creator_code:org_t)
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In:World Neurosurgery: ELSEVIER SCIENCE INC112, s. E624-E6311878-87501878-8769
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