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A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas

Al-Shudifat, Abdul Rahman Mohummad LU ; Kahlon, Babar LU ; Höglund, Peter LU ; Lindberg, Sven LU ; Magnusson, Måns LU and Siesjö, Peter LU (2016) In World Neurosurgery 94. p.2-550
Abstract

OBJECTIVE: Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity.

METHODS: There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed... (More)

OBJECTIVE: Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity.

METHODS: There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis.

RESULTS: All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity.

CONCLUSIONS: Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery.

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author
publishing date
type
Contribution to journal
publication status
published
in
World Neurosurgery
volume
94
pages
2 - 550
publisher
Elsevier
external identifiers
  • scopus:84992145946
ISSN
1878-8750
DOI
10.1016/j.wneu.2016.07.043
language
English
LU publication?
no
id
b1cf6250-5d75-41fc-bf20-b9169de2c087
date added to LUP
2017-05-03 11:45:40
date last changed
2017-10-01 05:33:49
@article{b1cf6250-5d75-41fc-bf20-b9169de2c087,
  abstract     = {<p>OBJECTIVE: Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity.</p><p>METHODS: There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis.</p><p>RESULTS: All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity.</p><p>CONCLUSIONS: Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery.</p>},
  author       = {Al-Shudifat, Abdul Rahman Mohummad and Kahlon, Babar and Höglund, Peter and Lindberg, Sven and Magnusson, Måns and Siesjö, Peter},
  issn         = {1878-8750},
  language     = {eng},
  pages        = {2--550},
  publisher    = {Elsevier},
  series       = {World Neurosurgery},
  title        = {A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas},
  url          = {http://dx.doi.org/10.1016/j.wneu.2016.07.043},
  volume       = {94},
  year         = {2016},
}