Department of Neurology, University Hospital Zurich and University of Zurich, Frauenklinikstrasse 26, 8091, Zurich, Switzerland.
Qual Life Res. 2020 Jul;29(7):1801-1808. doi: 10.1007/s11136-020-02461-1. Epub 2020 Mar 3.
Long-term impairment of quality of life (QoL) occurs in a subset of meningioma patients, even after curative surgical resection. We sought to explore socioeconomic burden of meningioma surgery and associations with post-operative QoL to identify patients at risk for inferior outcome.
All patients with histological diagnosis of an intracranial meningioma treated at a single institution 2000-2013 were screened for inclusion in this cross-sectional survey study. Surveys comprised tools to assess socioeconomic status including social deprivation, QoL and symptom burden. Multivariate binary regression models controlling for established prognostic factors were applied to explore associations of socioeconomics with QoL 1 year after surgery.
Completed surveys were returned by 249 patients. The median age at diagnosis was 56 years (SD ± 12), 185 patients (74%) were female and 219 (88%) had World Health Organization grade I meningiomas. One year after surgery, there was a 20% decrease in the number of patients working (p < 0.001), 22% of full-time working patients transitioned to part-time work (p < 0.001) and more patients depended on professional care (14% versus 4%, p < 0.001). Patients reported improved QoL, including improved global health (effect: 21%, 95% confidence interval [1] 15-26%), headaches (effect: 19%, CI 13-24%) and seizures (effect: 12%, CI 8-17%). On multivariable analyses, QoL after meningioma surgery was associated with preoperative employment status (odds ratio [OR] 0.41, 95% CI 0.17-0.98) and subjective work ability (OR 0.37, 95% CI 0.15-0.92).
In a subset of meningioma patients, there is marked socioeconomic burden, which may be associated with inferior patient-reported outcome.
即使在接受根治性手术切除后,仍有一部分脑膜瘤患者会出现长期的生活质量(QoL)受损。我们试图探讨脑膜瘤手术的社会经济学负担及其与术后 QoL 的关系,以确定预后不良的风险患者。
对 2000 年至 2013 年在一家机构接受颅内脑膜瘤组织学诊断的所有患者进行筛选,纳入本横断面调查研究。调查工具包括评估社会经济地位的工具,包括社会剥夺、QoL 和症状负担。应用多变量二元回归模型,控制既定预后因素,探讨社会经济学与术后 1 年 QoL 的关系。
完成的调查共收回 249 份。诊断时的中位年龄为 56 岁(标准差±12),185 名患者(74%)为女性,219 名患者(88%)为世界卫生组织一级脑膜瘤。术后 1 年,工作的患者数量减少了 20%(p<0.001),22%的全职工作患者转为兼职工作(p<0.001),更多的患者需要专业护理(14%比 4%,p<0.001)。患者报告 QoL 得到改善,包括总体健康状况改善(效应:21%,95%置信区间[1]15-26%)、头痛改善(效应:19%,CI 13-24%)和癫痫发作改善(效应:12%,CI 8-17%)。多变量分析显示,脑膜瘤手术后的 QoL 与术前就业状况(优势比[OR]0.41,95%置信区间[1]0.17-0.98)和主观工作能力(OR 0.37,95%置信区间[1]0.15-0.92)相关。
在一部分脑膜瘤患者中,存在显著的社会经济学负担,这可能与患者报告的预后不良有关。