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Therefore, we investigated the risk factors for unfavourable outcomes after shunt surgery in iNPH patients using two samples from Tohoku University Hospital and from a multicentre prospective trial of lumboperitoneal (LP) shunt surgery for patients with iNPH (SINPHONI-2). We enrolled 158 iNPH patients. We compared the prevalence of VRFs and clinical measures between patients with favourable and unfavourable outcomes and identified predictors of unfavourable outcomes using multivariate logistic regression analyses. The presence of hypertension, longer disease duration, more severe urinary dysfunction, and a lower Evans\u2019 index were predictors of unfavourable outcomes after shunt surgery. In addition, hypertension and longer disease duration were also predictors in patients with independent walking, and a lower Evans\u2019 index was the only predictor in patients who needed assistance to walk or could not walk. Our findings indicate that hypertension is the only VRF related to unfavourable outcomes after shunt surgery in iNPH patients. Larger-scale studies are needed to elucidate the reason why hypertension can affect the irreversibility of symptoms after shunt placement.<\/jats:p>","DOI":"10.1038\/s41598-022-18209-5","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T09:03:09Z","timestamp":1660726989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Risk factors for unfavourable outcomes after shunt surgery in patients with idiopathic normal-pressure hydrocephalus"],"prefix":"10.1038","volume":"12","author":[{"given":"Erena","family":"Kobayashi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigenori","family":"Kanno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuko","family":"Kawakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Narita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kazui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Miyajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatsune","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuro","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teiji","family":"Tominaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"18209_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1056\/NEJM196507152730301","volume":"273","author":"RD Adams","year":"1965","unstructured":"Adams, R. 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S.Y. received grants from the G-7 Scholarship Foundation, Taiju Life Social Welfare Foundation, and FUJIFILM Corporation and speaker honoraria from Fujifilm Medical Systems, Integra Japan, and Daiichi Sankyo, outside the submitted work. K.I. received funding for speaker honoraria from Nihon Medi-Physics. H.K. received funding for travel and\/or speaker honoraria from Integra Japan, Nihon Medi-Physics, Ono Pharmaceutical, Pfizer, Eisai, Daiichi-Sankyo, Janssen Pharmaceutical, Takeda Pharmaceutical, Novartis Pharma and Medtronic Inc. and receives research support from MSD KK, Daiichi-Sankyo, Eisai, a Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research, a Health Labour Sciences Research Grant, and the Japan Agency for Medical Research and Development. M.M. received funding for travel and\/or speaker honoraria from Integra Japan, Nihon Medi-Physics, Medtronic, Novartis Pharma, Eisai and Daiichi-Sankyo. M.I. received speaker honoraria from Integra Japan, Nihon Medi-Physics, Medtronic and Eisai. E.M. received speaker honoraria from Eisai, Daiichi-Sankyo, Novartis Pharma, Integra Japan, Nihon Medi-Physics, Janssen Pharmaceutical, Medtronic, Otsuka, Tanabe-Mitsubishi, Ono, and Fujifilm Medical; served as a consultant for Lundbeck; and received research support from Eisai, Daiichi-Sankyo, Novartis Pharma, Tanabe-Mitsubishi, Fujifilm Medical, and the Ministry of Health, Labour and Welfare Japan. T.T., F.T., and K.S. have no competing interests to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13921"}}