Health-related quality of life and emotional well-being after epilepsy surgery: A prospective, controlled, long-term follow-up
Health-related quality of life and emotional well-being after epilepsy surgery: A prospective, controlled, long-term follow-up
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DOI：
10.1111/epi.13874
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发表时间：
2017-10-01
期刊：
影响因子：
5.6
通讯作者：
Malmgren, Kristina
中科院分区：
文献类型：
--
作者：
Edelvik, Anna;Taft, Charles;Malmgren, Kristina
目的评价癫痫切除手术患者和非手术患者的健康相关生活质量（HRQOL）和情绪幸福感，并进行长期随访。方法这是一项前瞻性队列研究，1995-1998年期间接受手术前检查的患者在基线时完成了简明健康调查表（SF-36）和医院焦虑抑郁量表（HAD），术后2年和14年（非手术患者）。将SF-36评分与正常人群进行比较。达到HRQOL变化的最小临床重要的差异（MCID）的患者比例calculated.ResultsAt 14年的随访，手术患者得分等于或优于所有SF-36域的规范样本，除社会功能和心理健康。与正常样本相比，身体成分总结（PCS）更好，心理成分总结（MCS）更差。非手术患者在8个领域中的5个领域以及PCS和MCS上的得分低于正常样本。癫痫发作状态从2年到14年的变化不影响PCS或MCS平均值。从基线到长期，在50%（PCS）和47%（MCS）的手术患者以及33%（PCS）和38%（MCS）的非手术患者中观察到MCID改善。在18%（PCS）和22%（MCS）的手术患者以及38%（PCS）和38%（MCS）的非手术患者中观察到恶化。组间差异不显著。两组之间的HAD评分没有差异，可能或很可能的病例数很低。无手术并发症的患者对手术的满意度更高。只有5%的所有手术患者认为手术不是整体benefit.Significanceat组的水平，HRQOL是稳定的手术后14年相比，20年后。社会功能和心理健康仍然低于标准样本，但其他领域与标准样本相似。个体模式并不遵循癫痫发作结局的变化，表明多种因素对长期HRQOL很重要。
ObjectiveTo evaluate health-related quality of life (HRQOL) and emotional well-being in resective epilepsy surgery and nonoperated patients at long-term follow-up.MethodsThis is a prospective cohort study where patients undergoing presurgical work-up during 1995-1998 completed the Short-Form Health Survey (SF-36) and the Hospital Anxiety and Depression scale (HAD) at baseline, and 2 and 14years after resective surgery or presurgical evaluation (nonoperated patients). SF-36 scores were compared to a normative population. Proportions of patients reaching HRQOL changes of minimum clinically important difference (MCID) were calculated.ResultsAt 14-year follow-up, operated patients scored equal to or better than the normative sample on all SF-36 domains except Social Functioning and Mental Health. Physical component summary (PCS) was better and mental component summary (MCS) was worse than for the normative sample. Nonoperated patients scored worse than the normative sample on five of eight domains, and on PCS and MCS. Change in seizure status from 2 to 14years did not affect PCS or MCS means. Improvement reaching MCID from baseline to long-term was seen in 50% (PCS) and 47% (MCS) of operated and in 33% (PCS) and 38% (MCS) of nonoperated patients. Worsening was seen in 18% (PCS) and 22% (MCS) of operated and in 38% (PCS) and 38% (MCS) of nonoperated patients. Differences between groups were nonsignificant. HAD scores did not differ between groups, and the numbers of possible or probable cases were low. Patient satisfaction with surgery was higher in operated seizure-free patients. Only 5% of all operated patients considered surgery not to be overall beneficial.SignificanceAt the group level, HRQOL was stable 14years after surgery compared to after 2years. Social Functioning and Mental Health were still below, but other domains were similar to the normative sample. Individual patterns did not follow seizure outcome changes, indicating that multiple factors are important for long-term HRQOL.