Mustafa Mohammad A, Millward Christopher P, Gillespie Conor S, Richardson George E, Clynch Abigail L, Keshwara Sumirat M, Doherty John, Humphries Thomas, Islim Abdurrahman I, Duncan Christian, McMahon Catherine J, Brodbelt Andrew R, Jenkinson Michael D, Sinha Ajay
University of Liverpool, Liverpool, UK.
The Walton Centre NHS Foundation Trust, Liverpool, UK.
Neurosurg Rev. 2025 Jan 14;48(1):45. doi: 10.1007/s10143-024-03158-6.
Cranioplasty is an operation that aims to repair a defect in the skull. Indications commonly include Traumatic Brain Injury (TBI), tumours, and infections. It carries a high rate of postoperative morbidity. Due to underlying pathology and the nature of the operation patients' Health-related Quality of life (QoL) can be severely affected. Patient reported outcomes (PROs) are poorly understood following cranioplasty. To investigate PROs following cranioplasty a cross-sectional cohort study of adults undergoing cranioplasty between 01/03/2010-30/08/2020 was conducted. If consent was provided, participants were sent five health reporting questionnaires: a study specific questionnaire, EuroQoL - 5D - 5L (EQ-5D-5L), RAND Short-Form 36 (SF-36), Hospital Anxiety and Depression Scale (HADS), and Derriford Appearance Scale (DAS-24). 239 eligible patients were contacted and 72 (30.8%) participated. Median [Range] age was 52.5 [23 - 95] of which 59.7% (n= 43) were male. 16.9% (n = 12) were categorised with borderline and 29.0% (n = 20) with extreme depression, 15.9% (n = 11) reported borderline and 35.2% (n = 25) extreme anxiety. 69.1% (n = 47) had problems with usual activities and 71.6% (n = 49) suffered from pain/discomfort. Median (Range) EQ-5D-5L visual analogue scale score for overall health was 70.0 (5-100). 76.0% (n = 53) reported feeling conscious or having negative feelings towards their appearance. When compared to normative UK population, physical functioning, overall health, and energy/fatigue were the most affected. After cranioplasty, patients may have reduced HRQoL. Signposting and referral to well-being services could benefit patients' care. Adequately powered longitudinal studies are required to further elucidate change in PROs following cranioplasty.
颅骨修补术是一种旨在修复颅骨缺损的手术。其适应症通常包括创伤性脑损伤（TBI）、肿瘤和感染。该手术术后发病率较高。由于潜在的病理状况和手术性质，患者的健康相关生活质量（QoL）可能会受到严重影响。颅骨修补术后患者报告结局（PROs）的情况尚不清楚。为了调查颅骨修补术后的PROs，对2010年3月1日至2020年8月30日期间接受颅骨修补术的成年人进行了一项横断面队列研究。如果获得同意，参与者会收到五份健康报告问卷：一份研究专用问卷、欧洲五维健康量表 - 5D - 5L（EQ - 5D - 5L）、兰德36项简明健康调查问卷（SF - 36）、医院焦虑抑郁量表（HADS）和德里福德外貌量表（DAS - 24）。联系了239名符合条件的患者，72名（30.8%）参与了研究。年龄中位数[范围]为52.5岁[23 - 95岁]，其中59.7%（n = 43）为男性。16.9%（n = 12）被归类为边缘性抑郁，29.0%（n = 20）为重度抑郁，15.9%（n = 11）报告为边缘性焦虑，35.2%（n = 25）为重度焦虑。69.1%（n = 47）在日常活动方面存在问题，71.6%（n = 49）有疼痛/不适。EQ - 5D - 5L总体健康视觉模拟量表评分中位数（范围）为70.0（5 - 100）。76.0%（n = 53）报告对自己的外貌感到在意或有负面情绪。与英国正常人群相比，身体功能、总体健康和精力/疲劳受到的影响最大。颅骨修补术后，患者的健康相关生活质量可能会降低。提供指引并转介至福利服务可能有益于患者护理。需要开展有足够样本量的纵向研究，以进一步阐明颅骨修补术后患者报告结局的变化情况。
