PMID- 29374607
OWN - NLM
STAT- MEDLINE
DCOM- 20180521
LR  - 20180521
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 112
DP  - 2018 Apr
TI  - Incidence, Comorbidities, and Mortality in Idiopathic Normal 
      Pressure Hydrocephalus.
PG  - e624-e631
LID - S1878-8750(18)30150-5 [pii]
LID - 10.1016/j.wneu.2018.01.107 [doi]
AB  - 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 hyperphosphorylated 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.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Pyykko, Okko T
AU  - Pyykko OT
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland. 
      Electronic address: okko.pyykko@phhyky.fi.
FAU - Nerg, Ossi
AU  - Nerg O
AD  - Neurology of NeuroCenter, Kuopio University Hospital, and Institute of Clinical 
      Medicine - Neurology, University of Eastern Finland, Kuopio, Finland.
FAU - Niskasaari, Hanna-Mari
AU  - Niskasaari HM
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
FAU - Niskasaari, Timo
AU  - Niskasaari T
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
FAU - Koivisto, Anne M
AU  - Koivisto AM
AD  - Neurology of NeuroCenter, Kuopio University Hospital, and Institute of Clinical 
      Medicine - Neurology, University of Eastern Finland, Kuopio, Finland.
FAU - Hiltunen, Mikko
AU  - Hiltunen M
AD  - Institute of Biomedicine, University of Eastern Finland, Department of Neurology, 
      Kuopio University Hospital, Kuopio, Finland.
FAU - Pihlajamaki, Jussi
AU  - Pihlajamaki J
AD  - Department of Clinical Nutrition, Institute of Public Health and Clinical 
      Nutrition, University of Eastern Finland, and Clinical Nutrition and Obesity 
      Center, Kuopio University Hospital, Kuopio, Finland.
FAU - Rauramaa, Tuomas
AU  - Rauramaa T
AD  - Department of Pathology, Kuopio University Hospital, and Institute of Clinical 
      Medicine - Pathology, University of Eastern Finland, Kuopio, Finland.
FAU - Kojoukhova, Maria
AU  - Kojoukhova M
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
FAU - Alafuzoff, Irina
AU  - Alafuzoff I
AD  - Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, 
      Sweden.
FAU - Soininen, Hilkka
AU  - Soininen H
AD  - Neurology of NeuroCenter, Kuopio University Hospital, and Institute of Clinical 
      Medicine - Neurology, University of Eastern Finland, Kuopio, Finland.
FAU - Jaaskelainen, Juha E
AU  - Jaaskelainen JE
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
FAU - Leinonen, Ville
AU  - Leinonen V
AD  - Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
LA  - eng
PT  - Journal Article
DEP - 20180131
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiovascular Diseases/*epidemiology
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - Humans
MH  - Hydrocephalus, Normal Pressure/diagnostic imaging/*epidemiology/mortality
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Neuroimaging
MH  - Survival Rate
OTO - NOTNLM
OT  - Cause of death
OT  - Comorbidity
OT  - Incidence
OT  - Mortality
OT  - Normal pressure hydrocephalus
OT  - Survival
EDAT- 2018/01/29 06:00
MHDA- 2018/05/22 06:00
CRDT- 2018/01/29 06:00
PHST- 2017/11/05 00:00 [received]
PHST- 2018/01/14 00:00 [revised]
PHST- 2018/01/15 00:00 [accepted]
PHST- 2018/01/29 06:00 [pubmed]
PHST- 2018/05/22 06:00 [medline]
PHST- 2018/01/29 06:00 [entrez]
AID - S1878-8750(18)30150-5 [pii]
AID - 10.1016/j.wneu.2018.01.107 [doi]
PST - ppublish
SO  - World Neurosurg. 2018 Apr;112:e624-e631. doi: 10.1016/j.wneu.2018.01.107. Epub 
      2018 Jan 31.