Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Seizure. 2020 Jan;74:1-7. doi: 10.1016/j.seizure.2019.11.004. Epub 2019 Nov 11.
The aim of this study was to compare parent-reported Health Related Quality of Life (HRQoL) and behaviour of young people before (baseline) and two years after paediatric epilepsy surgery (follow-up).
The parents of 107 children who underwent epilepsy surgery completed surveys focussing on different aspects of child HRQoL and behaviour at baseline and follow-up. Parents of children with multiple disabilities (n = 27) completed five additional questions focussing on child HRQoL. Changes in scores between baseline and follow-up were compared using Wilcoxon signed-rank tests. Factors associated with changes in scores were analyzed using linear regression.
HRQoL and behaviour were significantly improved at follow-up (p < 0.001). HRQoL was also significantly improved for children with multiple disabilities (p = 0.003). Factors independently associated with improvement in HRQoL on multivariable analysis were lower baseline scores (p < 0.001), seizure-free status (p < 0.001) and improvement in behaviour (p = 0.022). Factors independently associated with improvement in behaviour were higher baseline difficulties (p < 0.001), reduction in antiepileptic drug (AED) usage, (p < 0.001), seizure-free status (p = 0.04), younger age (p = 0.03), and improvements in HRQoL (p = 0.028).
Parent rated HRQoL and behaviour had improved two years after epilepsy surgery. Seizure freedom was associated with both improvements in HRQoL and behaviour. Additionally, a reduction in AED usage contributed to reduced behavioural difficulties. All children undergoing epilepsy surgery should undergo assessment of HRQoL and behaviour at baseline and follow-up.
本研究旨在比较患儿父母报告的健康相关生活质量（HRQoL）和行为，这些患儿在接受儿科癫痫手术后（随访）之前（基线）和两年后。
107 名接受癫痫手术的儿童的父母在基线和随访时完成了专注于儿童 HRQoL 和行为的不同方面的调查。有多种残疾的儿童的父母（n=27）完成了另外五个问题，重点是儿童 HRQoL。使用 Wilcoxon 符号秩检验比较基线和随访之间评分的变化。使用线性回归分析与评分变化相关的因素。
随访时 HRQoL 和行为明显改善（p<0.001）。患有多种残疾的儿童的 HRQoL 也显著改善（p=0.003）。多变量分析中与 HRQoL 改善独立相关的因素是基线评分较低（p<0.001）、无癫痫发作状态（p<0.001）和行为改善（p=0.022）。与行为改善独立相关的因素是基线时困难程度较高（p<0.001）、减少抗癫痫药物（AED）使用量（p<0.001）、无癫痫发作状态（p=0.04）、年龄较小（p=0.03）以及 HRQoL 改善（p=0.028）。
癫痫手术后两年，父母评定的 HRQoL 和行为均有所改善。癫痫无发作与 HRQoL 和行为的改善均相关。此外，减少 AED 使用有助于减少行为困难。所有接受癫痫手术的儿童都应在基线和随访时进行 HRQoL 和行为评估。
