Abstract：
Although shunting has been shown to ameliorate symptoms in idiopathic normal pressure hydrocephalus (iNPH), its impact on health-related quality of life (HRQoL) has yet to be fully elucidated. Patient and caregiver subjective life satisfaction and HRQoL represent crucial indicators for assessing the well-being of individuals facing chronic illnesses, including iNPH. This study aimed to systematically analyze the existing data about HRQoL in iNPH-treated patients to evaluate the role of surgical treatment in such a scenario.
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the literature in the PubMed/Medline, Web of Science, and Scopus databases was searched. Fourteen studies met our inclusion criteria. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias.
Overall, HRQoL improved significantly within 1 year after shunt placement although patients with iNPH reported worse HRQoL values compared with healthy-matched individuals. Up to 5 years after shunting, a sustained heterogeneity exists on published data showing improved scores across all domains for at least 21 months after shunting. Further, although surgical treatment can improve HRQoL, long-term follow-up showed that it remained lower than that of healthy controls. These data suggest a significant decrease of HRQoL in patients with iNPH over time after shunting, probably due to aging, comorbidities, and disease progression.
Despite that iNPH has been recognized as a potentially reversible neurological disorder, the available data about the impact of shunting on the HRQoL are unsatisfactory. To improve the well-informed clinical decision-making, it is essential to reach additional high-quality evidence regarding the effect of shunting on HRQoL. New prospective studies, using validated instruments specifically tailored for assessing HRQoL in patients with iNPH, and improved reporting standards are needed. Current evidence suggests that although shunting can provide initial benefits, affected patients may experience long-term impairment in HRQoL.
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the literature in the PubMed/Medline, Web of Science, and Scopus databases was searched. Fourteen studies met our inclusion criteria. The Joanna Briggs Institute critical appraisal tool was used to assess the risk of bias.
Overall, HRQoL improved significantly within 1 year after shunt placement although patients with iNPH reported worse HRQoL values compared with healthy-matched individuals. Up to 5 years after shunting, a sustained heterogeneity exists on published data showing improved scores across all domains for at least 21 months after shunting. Further, although surgical treatment can improve HRQoL, long-term follow-up showed that it remained lower than that of healthy controls. These data suggest a significant decrease of HRQoL in patients with iNPH over time after shunting, probably due to aging, comorbidities, and disease progression.
Despite that iNPH has been recognized as a potentially reversible neurological disorder, the available data about the impact of shunting on the HRQoL are unsatisfactory. To improve the well-informed clinical decision-making, it is essential to reach additional high-quality evidence regarding the effect of shunting on HRQoL. New prospective studies, using validated instruments specifically tailored for assessing HRQoL in patients with iNPH, and improved reporting standards are needed. Current evidence suggests that although shunting can provide initial benefits, affected patients may experience long-term impairment in HRQoL.
摘要：
目的：虽然分流已被证明可以改善特发性正常压力脑积水（iNPH）的症状，其对健康相关生活质量（HRQoL）的影响尚未完全阐明。患者和护理人员主观生活满意度，以及HRQoL代表评估面临慢性病的个人福祉的关键指标，包括iNPH。本研究旨在系统分析iNPH治疗患者HRQoL的现有数据，以评估手术治疗在这种情况下的作用。
方法：使用PRISMA指南，PubMed/Medline中的文献，WebofScience,搜索了Scopus数据库.14项研究符合我们的纳入标准。乔安娜·布里格斯研究所的关键评估工具被用来评估偏差的风险。
结果：总体而言，尽管与健康匹配的个体相比，iNPH患者的HRQoL值较差，但在分流放置后的一年内HRQoL显着改善。调车后长达5年，在已发表的数据上存在持续的异质性,这些数据显示在分流后至少21个月内所有领域的评分都得到改善.Further,虽然手术治疗可以改善HRQoL，长期随访表明，它仍然低于健康对照组。这些数据表明，随着时间的推移，iNPH患者的HRQoL显着降低，可能是由于衰老,合并症,和疾病进展。
结论：尽管iNPH被认为是一种潜在的可逆性神经系统疾病，关于分流对HRQoL影响的现有数据并不令人满意。为了提高知情的临床决策，必须获得有关分流对HRQoL影响的更多高质量证据。新的前瞻性研究,使用经过验证的专门为评估iNPH患者的HRQoL而定制的仪器，需要改进报告标准。目前的证据表明，虽然分流可以提供初步的好处，受影响的患者可能会出现长期的HRQoL受损。
方法：使用PRISMA指南，PubMed/Medline中的文献，WebofScience,搜索了Scopus数据库.14项研究符合我们的纳入标准。乔安娜·布里格斯研究所的关键评估工具被用来评估偏差的风险。
结果：总体而言，尽管与健康匹配的个体相比，iNPH患者的HRQoL值较差，但在分流放置后的一年内HRQoL显着改善。调车后长达5年，在已发表的数据上存在持续的异质性,这些数据显示在分流后至少21个月内所有领域的评分都得到改善.Further,虽然手术治疗可以改善HRQoL，长期随访表明，它仍然低于健康对照组。这些数据表明，随着时间的推移，iNPH患者的HRQoL显着降低，可能是由于衰老,合并症,和疾病进展。
结论：尽管iNPH被认为是一种潜在的可逆性神经系统疾病，关于分流对HRQoL影响的现有数据并不令人满意。为了提高知情的临床决策，必须获得有关分流对HRQoL影响的更多高质量证据。新的前瞻性研究,使用经过验证的专门为评估iNPH患者的HRQoL而定制的仪器，需要改进报告标准。目前的证据表明，虽然分流可以提供初步的好处，受影响的患者可能会出现长期的HRQoL受损。
