Ghadiri Fereshteh, Ebadi Zahra, Asadollahzadeh Elnaz, Sahraian Mohammad Ali, Azimi Amirreza, Navardi Samira, Heidari Hora, Abna Zohreh, Aboutorabi Marzieh, Adibi Iman, Baghbanian Seyed Mohammad, Paybast Sepideh, Poursadeghfard Maryam, Hosseini Samaneh, Shahmohammadi Sareh, Ghaffari Mehran, Ghalyanchi-Langroodi Hamidreza, Ghiasian Masoud, Kamali Hoda, Kouchaki Ebrahim, Mahrabi Farzad, Mohammadianinejad Ehsan, Nahayati Mohammad Ali, Moghadasi Abdorreza Naser
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Curr J Neurol. 2023 Apr 4;22(2):96-102. doi: 10.18502/cjn.v22i2.13336.
Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists' approach to surgical counseling for patients with MS (PwMS). 21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation. The reasons for refusing surgery or factors that have to be considered before surgery were studied. Overall, Fleiss Kappa was estimated to be 0.091 [95% confidence interval (CI): 0.090-0.093, P < 0.001] indicating a very poor level of agreement among responders. PwMS face surgery for various reasons. Risk assessment of surgery, the effect of various drugs such as anesthetics and DMT on patients, as well as many other aspects of MS are issues challenging the practitioners. Clarifying the various dimensions of these issues requires further research.
关于多发性硬化症（MS）患者围手术期风险分层的数据有限。在这方面，本研究旨在调查伊朗专家对MS患者（PwMS）进行手术咨询的方法。向21名MS专家询问了11种具有不同MS疾病状态、疾病修饰疗法（DMT）和手术紧迫性的病例情况。研究了拒绝手术的原因或手术前必须考虑的因素。总体而言，Fleiss Kappa估计为0.091[95%置信区间（CI）：0.090 - 0.093，P < 0.001]，表明应答者之间的一致性水平非常低。PwMS因各种原因接受手术。手术风险评估、麻醉剂和DMT等各种药物对患者的影响以及MS的许多其他方面都是困扰从业者的问题。阐明这些问题的各个方面需要进一步研究。
