{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:18:05Z","timestamp":1793830685727,"version":"4.6.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T00:00:00Z","timestamp":1640822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Idiopathic normal pressure hydrocephalus (iNPH) is a disease that comes with a great impact on the patient\u2019s life. The only treatment for iNPH, which is a progressive disease, is shunt surgery. It is previously indicated that early intervention might be of importance for the outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aim<\/jats:title>\n                <jats:p>To investigate if a longer waiting time for surgery, negatively influences the clinical outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Eligible for this study were all iNPH patients (n\u2009=\u20093007) registered in the Swedish Hydrocephalus Quality Registry (SHQR) during 1<jats:sup>st<\/jats:sup> of January 2004\u201312<jats:sup>th<\/jats:sup> of June 2019. Waiting time, defined as time between the decision to accept a patient for surgery and shunt surgery, was divided into the intervals\u2009\u2264\u20093, 3.1\u20135.9 and\u2009\u2265\u20096\u00a0months. Clinical outcome was assessed 3 and 12\u00a0months after surgery using the modified iNPH scale, the Timed Up and Go (TUG) test and the mini mental state examination (MMSE).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three months after surgery, 57% of the patients with\u2009\u2264\u20093\u00a0months waiting time showed an improvement in modified iNPH scale (\u2265\u20095 points) whereas 52% and 46% of patients with 3.1\u20135.9 and\u2009\u2265\u20096\u00a0months waiting time respectively improved (p\u2009=\u20090.0115). At 12\u00a0months of follow-up, the corresponding numbers were 61%, 52% and 51% respectively (p\u2009=\u20090.0536).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This population-based study showed that in patients with iNPH, shunt surgery should be performed within 3\u00a0months of decision to surgery, to attain the best outcome.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-021-05085-7","type":"journal-article","created":{"date-parts":[[2021,12,30]],"date-time":"2021-12-30T20:02:29Z","timestamp":1640894549000},"page":"469-478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Waiting time for surgery influences the outcome in idiopathic normal pressure hydrocephalus \u2014 a population-based study"],"prefix":"10.1007","volume":"164","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0830-4108","authenticated-orcid":false,"given":"Christine","family":"Chidiac","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Tullberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Arvidsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Olivecrona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,30]]},"reference":[{"key":"5085_CR1","doi-asserted-by":"publisher","first-page":"e0217705","DOI":"10.1371\/journal.pone.0217705","volume":"14","author":"J Andersson","year":"2019","unstructured":"Andersson J, Rosell M, Kockum K, Lilja-Lund O, S\u00f6derstr\u00f6m L, Laurell K (2019) Prevalence of idiopathic normal pressure hydrocephalus: a prospective, population-based study. PLoS ONE 14:e0217705. https:\/\/doi.org\/10.1371\/journal.pone.0217705","journal-title":"PLoS ONE"},{"key":"5085_CR2","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/jnnp-2013-306117","volume":"85","author":"K Andr\u00e9n","year":"2014","unstructured":"Andr\u00e9n K, Wikkels\u00f8 C, Tisell M, Hellstr\u00f6m P (2014) Natural course of idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 85:806\u2013810. https:\/\/doi.org\/10.1136\/jnnp-2013-306117","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"5085_CR3","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13200","author":"H B\u00e5dag\u00e5rd","year":"2019","unstructured":"B\u00e5dag\u00e5rd H, Braun M, Nilsson D, Stridh L, Virhammar J (2019) Negative predictors of shunt surgery outcome in normal pressure hydrocephalus. Acta Neurol Scand. https:\/\/doi.org\/10.1111\/ane.13200","journal-title":"Acta Neurol Scand"},{"key":"5085_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-019-04259-8","author":"AG Doumouras","year":"2019","unstructured":"Doumouras AG, Albacete S, Mann A, Gmora S, Anvari M, Hong D (2019) A longitudinal analysis of wait times for bariatric surgery in a publicly funded, regionalized bariatric care system. Obes Surg. https:\/\/doi.org\/10.1007\/s11695-019-04259-8","journal-title":"Obes Surg"},{"key":"5085_CR5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","volume":"12","author":"MF Folstein","year":"1975","unstructured":"Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. J Psychiatr Res 12:189\u2013198. https:\/\/doi.org\/10.1016\/0022-3956(75)90026-6","journal-title":"J Psychiatr Res"},{"key":"5085_CR6","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/0022-510X(65)90016-X","volume":"2","author":"S Hakim","year":"1965","unstructured":"Hakim S, Adams RD (1965) The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. J Neurol Sci 2:307\u2013327. https:\/\/doi.org\/10.1016\/0022-510X(65)90016-X","journal-title":"J Neurol Sci"},{"key":"5085_CR7","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1111\/j.1600-0404.2012.01677.x","volume":"126","author":"P Hellstr\u00f6m","year":"2012","unstructured":"Hellstr\u00f6m P, Klinge P, Tans J, Wikkels\u00f8 C (2012) A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand 126:229\u2013237. https:\/\/doi.org\/10.1111\/j.1600-0404.2012.01677.x","journal-title":"Acta Neurol Scand"},{"key":"5085_CR8","doi-asserted-by":"publisher","first-page":"197","DOI":"10.2176\/nmc.48.197","volume":"48","author":"K Hiraoka","year":"2008","unstructured":"Hiraoka K, Meguro K, Mori E (2008) Prevalence of idiopathic normal-pressure hydrocephalus in the elderly population of a Japanese rural community. Neurol Med Chir (Tokyo) 48:197\u2013200. https:\/\/doi.org\/10.2176\/nmc.48.197","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"5085_CR9","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.1212\/WNL.0000000000000342","volume":"82","author":"D Jaraj","year":"2014","unstructured":"Jaraj D, Rabiei K, Marlow T, Jensen C, Skoog I, Wikkels\u00f8 C (2014) Prevalence of idiopathic normal-pressure hydrocephalus. Neurology 82:1449\u20131454. https:\/\/doi.org\/10.1212\/WNL.0000000000000342","journal-title":"Neurology"},{"key":"5085_CR10","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/j.1600-0404.2012.01676.x","volume":"126","author":"P Klinge","year":"2012","unstructured":"Klinge P, Hellstr\u00f6m P, Tans J, Wikkels\u00f8 C, On behalf of the European iNPH Multicentre Study Group (2012) One-year outcome in the European multicentre study on iNPH. Acta Neurol Scand 126:145\u2013153. https:\/\/doi.org\/10.1111\/j.1600-0404.2012.01676.x","journal-title":"Acta Neurol Scand"},{"key":"5085_CR11","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","volume":"39","author":"D Podsiadlo","year":"1991","unstructured":"Podsiadlo D, Richardson S (1991) The timed \u201cup & go\u201d: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142\u2013148. https:\/\/doi.org\/10.1111\/j.1532-5415.1991.tb01616.x","journal-title":"J Am Geriatr Soc"},{"key":"5085_CR12","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/j.spinee.2013.05.038","volume":"13","author":"JA Quon","year":"2013","unstructured":"Quon JA, Sobolev BG, Levy AR, Fisher CG, Bishop PB, Kopec JA, Dvorak MF, Schechter MT (2013) The effect of waiting time on pain intensity after elective surgical lumbar discectomy. Spine J 13:1736\u20131748. https:\/\/doi.org\/10.1016\/j.spinee.2013.05.038","journal-title":"Spine J"},{"key":"5085_CR13","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1016\/j.jocn.2008.12.007","volume":"16","author":"G Razay","year":"2009","unstructured":"Razay G, Vreugdenhil A, Liddell J (2009) A prospective study of ventriculo-peritoneal shunting for idiopathic normal pressure hydrocephalus. J Clin Neurosci 16:1180\u20131183. https:\/\/doi.org\/10.1016\/j.jocn.2008.12.007","journal-title":"J Clin Neurosci"},{"key":"5085_CR14","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1227\/01.neu.0000168185.29659.c5","volume":"57","author":"N Relkin","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM (2005) Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S4-16. https:\/\/doi.org\/10.1227\/01.neu.0000168185.29659.c5 (discussion ii-v)","journal-title":"Neurosurgery"},{"key":"5085_CR15","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3174\/ajnr.A0785","volume":"29","author":"A Scollato","year":"2008","unstructured":"Scollato A, Tenenbaum R, Bahl G, Celerini M, Salani B, Di Lorenzo N (2008) Changes in aqueductal CSF stroke volume and progression of symptoms in patients with unshunted idiopathic normal pressure hydrocephalus. Am J Neuroradiol 29:192\u2013197. https:\/\/doi.org\/10.3174\/ajnr.A0785","journal-title":"Am J Neuroradiol"},{"key":"5085_CR16","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/02688697.2016.1229749","volume":"31","author":"N Sundstr\u00f6m","year":"2017","unstructured":"Sundstr\u00f6m N, Malm J, Laurell K, Lundin F, Kahlon B, Cesarini KG, Leijon G, Wikkels\u00f6 C (2017) Incidence and outcome of surgery for adult hydrocephalus patients in Sweden. Br J Neurosurg 31:21\u201327. https:\/\/doi.org\/10.1080\/02688697.2016.1229749","journal-title":"Br J Neurosurg"},{"key":"5085_CR17","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1159\/000186501","volume":"32","author":"N Tanaka","year":"2009","unstructured":"Tanaka N, Yamaguchi S, Ishikawa H, Ishii H, Meguro K (2009) Prevalence of possible idiopathic normal-pressure hydrocephalus in Japan: the Osaki-Tajiri Project. Neuroepidemiology 32:171\u2013175. https:\/\/doi.org\/10.1159\/000186501","journal-title":"Neuroepidemiology"},{"key":"5085_CR18","doi-asserted-by":"publisher","first-page":"E2","DOI":"10.3171\/2016.6.FOCUS16146","volume":"41","author":"S Vakili","year":"2016","unstructured":"Vakili S, Moran D, Hung A, Elder BD, Jeon L, Fialho H, Sankey EW, Jusu\u00e9-Torres I, Goodwin CR, Lu J, Robison J, Rigamonti D (2016) Timing of surgical treatment for idiopathic normal pressure hydrocephalus: association between treatment delay and reduced short-term benefit. Neurosurg Focus 41:E2. https:\/\/doi.org\/10.3171\/2016.6.FOCUS16146","journal-title":"Neurosurg Focus"},{"key":"5085_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.10.013","author":"E Vasilyeva","year":"2019","unstructured":"Vasilyeva E, Li J, Desai S, Chung SW, Scudamore CH, Segedi M, Kim PT (2019) Impact of surgical wait times on oncologic outcomes in resectable pancreas adenocarcinoma. HPB. https:\/\/doi.org\/10.1016\/j.hpb.2019.10.013","journal-title":"HPB"},{"key":"5085_CR20","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1212\/CON.0000000000000305","volume":"22","author":"MA Williams","year":"2016","unstructured":"Williams MA, Malm J (2016) Diagnosis and treatment of idiopathic normal pressure hydrocephalus. Contin Minneap Minn 22:579\u2013599. https:\/\/doi.org\/10.1212\/CON.0000000000000305","journal-title":"Contin Minneap Minn"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-021-05085-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-021-05085-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-021-05085-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T08:12:15Z","timestamp":1645085535000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-021-05085-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,30]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["5085"],"URL":"https:\/\/doi.org\/10.1007\/s00701-021-05085-7","relation":{},"ISSN":["0001-6268","0942-0940"],"issn-type":[{"value":"0001-6268","type":"print"},{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,30]]},"assertion":[{"value":"20 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Swedish Ethical Review Authority (Dnr 2019\u201302542).In accordance with Swedish legislation and regulations regarding patient consent for participation in a national quality registry, before undergoing surgery patients are given written information about SHQR including the choice to opt-out from registration in SHQR or for their data to be removed from the register at any time.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}