Prevalence and Trends in Management of Idiopathic Normal Pressure Hydrocephalus in the United States: Insights from the National Inpatient Sample
Prevalence and Trends in Management of Idiopathic Normal Pressure Hydrocephalus in the United States: Insights from the National Inpatient Sample
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DOI：
10.1016/j.wneu.2020.09.012
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发表时间：
2021-01-01
影响因子：
2
通讯作者：
Elder, Benjamin D.
中科院分区：
文献类型：
--
作者：
Alvi, Mohammed Ali;Brown, Desmond;Elder, Benjamin D.
背景：在过去的20年里，特发性正常压力脑积水（iNPH）的治疗发生了显著变化。在目前的研究中，我们试图评估的国家患病率和管理趋势的iNPH在美国使用国家database.METHODS：国家住院患者样本进行了查询，从2007年到2017年的iNPH的国际疾病分类诊断代码的患者。使用加权出院率评价每100，000例出院率和出院率百分比的患病率和手术类型趋势。结果：从2007年到2017年，确定了302，460例年龄≥ 60岁的iNPH诊断代码加权出院。患病率为0.04%~ 0.20%（41/100，000至202/100，000），研究期间的平均患病率为0.18%（179/100，000）。在66，759例主要诊断代码为iNPH并接受手术治疗的加权出院中，脑室腹腔分流术（72.0%的出院病例，n = 48，977）是最常用的;其中，9.3%（n = 4567）是通过腹腔镜进行的。随后是腰椎腹膜分流术（占出院人数的15.1%，n = 10，441）。高达15.1%（n = 9990）例出院患者仅报告了腰椎穿刺，假设仅用于诊断、筛查或连续脑脊液清除程序的一部分。在西部、南部、东北部和中西部地区的医院之间，以及城市和农村医院之间，也发现了程序使用的显著差异结论：我们总结了全国iNPH的患病率，过去十年的管理趋势以及各地区和医院类型的趋势。
BACKGROUND: Over the past 2 decades, management of idiopathic normal pressure hydrocephalus (iNPH) has evolved significantly. In the current study, we sought to evaluate the national prevalence and management trends of iNPH in the United States using a national database.METHODS: The National Inpatient Sample was queried for patients with an International Classification of Diseases diagnosis code for iNPH from 2007 to 2017. Trends in prevalence and procedure type were evaluated per 100,000 discharges and as a percentage of discharges, using weighted discharges. Utilization of procedure type across U.S. regions and hospital types was also compared.RESULTS: From 2007 to 2017, 302,460 weighted discharges with any diagnosis code for iNPH, aged >= 60 years, were identified. Prevalence ranged from 0.04% to 0.20% (41/100,000 to 202/100,000) among admitted patients >= 60 years old, giving an average prevalence during the study duration of 0.18% (179/100,000).Of 66,759 weighted discharges with a primary diagnosis code of iNPH undergoing surgical management, ventriculoperitoneal shunt (72.0% of discharges, n = 48,977) was most commonly used; of these, 9.3% (n = 4567) were performed laparoscopically. This result was followed by lumbar peritoneal shunt (15.1% of discharges, n = 10,441). Up to 15.1% (n = 9990) of discharges reported only a lumbar puncture, assumed to be only diagnostic, for screening, or part of serial cerebrospinal fluid removal procedures.Significant discrepancies in procedure utilization were also identified among hospitals in the Western, Southern, Northeast and Midwest regions, as well as between urban and rural hospitals (P < 0.05).CONCLUSIONS: We have summarized the national prevalence of iNPH, trends in its management over the previous decade and trends by region and hospital type.