Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany.
Department of General Neurosurgery, Center for Neurosurgery, University Hospital Cologne, Cologne, Germany.
World Neurosurg. 2019 May;125:e697-e710. doi: 10.1016/j.wneu.2019.01.158. Epub 2019 Feb 5.
The incidence of meningiomas increases with increasing age. Because the median age for the diagnosis is 65 years, the patients' general health condition, comorbidities, and procedural risks will influence the postoperative functional outcomes. The aim of our study was to assess the long-term impairments of health-related quality of life (HRQOL) after meningioma resection in different age groups of elderly patients.
We analyzed the HRQOL of 133 patients aged >54 years at surgery who had undergone surgical meningioma resection from 2004 to 2010. The median age was 67.3 ± 7.4 years. The average interval between surgery and questionnaire completion was 3.8 ± 2.5 years. Six different 5-year age groups were established. The patients completed the Medical Outcomes Study short-form 36-item questionnaire, and the results were compared with general population values. The Kruskal-Wallis test and Mann-Whitney U test were used for statistical analysis.
We found significantly lower levels of physical function, vitality, social role functioning, mental health, and general health perception and significantly greater levels of pain between the older age groups (in particular, 75-79 years) and younger patients aged 55-59 years. The physical component summary showed a steadily and stepwise decline from younger to older patients. However, the most significant differences in HRQOL were not related to age but to comorbidities.
Our findings suggest that Karnofsky performance scale and American Society of Anesthesiologists scores have a strong effect on long-term HRQOL, especially for older patients after meningioma resection. These data should be a substantial consideration in the preoperative decision-making process.
脑膜瘤的发病率随年龄增长而增加。由于诊断的中位年龄为 65 岁，因此患者的一般健康状况、合并症和手术风险会影响术后的功能结果。我们的研究旨在评估不同年龄组老年脑膜瘤切除术后患者健康相关生活质量（HRQOL）的长期损害。
我们分析了 2004 年至 2010 年间接受手术脑膜瘤切除术的 133 名年龄>54 岁的患者的 HRQOL。中位年龄为 67.3±7.4 岁。手术与问卷完成之间的平均间隔为 3.8±2.5 年。建立了六个不同的 5 岁年龄组。患者完成了医疗结果研究简表 36 项问卷，并将结果与一般人群值进行了比较。使用 Kruskal-Wallis 检验和 Mann-Whitney U 检验进行统计学分析。
我们发现，与年轻患者（尤其是 55-59 岁）相比，年龄较大的患者（特别是 75-79 岁）的身体功能、活力、社会角色功能、心理健康和总体健康感知水平明显较低，疼痛水平明显较高。身体成分综合评分显示，从年轻患者到老年患者呈稳步、逐步下降。然而，HRQOL 的最大差异与年龄无关，而是与合并症有关。
我们的研究结果表明，卡诺夫斯基表现量表和美国麻醉医师协会评分对脑膜瘤切除术后的长期 HRQOL 有很大影响，尤其是对老年患者。这些数据应在术前决策过程中得到充分考虑。
