Quality of life in elderly patients after surgery for drug-resistant epilepsy - The impact of seizure outcome, neurological deficits and anxiety

被引:9
作者
Delev, Daniel [1 ]
Hakvoort, Karlijn [1 ]
Grote, Alexander [2 ]
Neuloh, Georg [1 ]
Clusmann, Hans [1 ]
von Lehe, Marec [3 ,4 ]
机构
[1] Rhein Westfal TH Aachen, Dept Neurosurg, Aachen, Germany
[2] Evangel Hosp Bethel, Clin Neurosurg, Bielefeld, Germany
[3] Brandenburg Med Sch, Dept Neurosurg, Ruppiner Kliniken, Neuruppin, Germany
[4] Univ Bonn, Med Fac, Med Ctr, Bonn, Germany
关键词
Epilepsy surgery; Elderly; Neuropsychology; HRQoL; Outcome; TEMPORAL-LOBE EPILEPSY; OLDER; SAFETY;
D O I
10.1016/j.yebeh.2020.107410
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
Introduction: Health related quality of life (HRQoL) has become a pivotal outcome parameter after surgery for drug-resistant epilepsy. The aim of the study was to investigate HRQoL and its relationship to seizure outcome, neurological deficits and anxiety after epilepsy surgery in a specific subpopulation of elderly patients. Methods: A total of 85 elderly patients (older than 50 years) answered a standardized HRQoL questionnaire one year after epilepsy surgery. The questionnaire addressed the present self-assessed HRQoL in four subdomains (physical function, cognitive function, mood, social interaction). The questionnaire was based on the "Epilepsy Surgery Inventory-55", adapted for use in German speaking patients and validated by the QOLIE - 10 and Beck Depression Inventory. Results: A total of 51 patients (60%) were completely seizure free (ILAE1) at last available outcome (LAO). Permanent neurological deficits were observed in 8 patients (7%). Correlation analysis confirmed significant association between seizure outcome and overall HRQoL (r = - 0.368, p < .001). New permanent neurological deficits showed impact on both HRQoL and the "cognitive function" subdomain. Anxiety and subjective assessment of postoperative status were strongly correlated with overall HRQoL (r = 0.692, p <.001 and r = 0.591, p <.001 respectively) and remained as independent prognostic factors in a multivariate regression analysis. Conclusion: Surgery for drug-resistant epilepsy in elderly improves patients HRQoL. Both seizure freedom and new neurological deficits influence overall HRQoL. Interestingly, anxiety and patients' subjective assessment of postoperative status showed the highest impact on HRQoL in this subpopulation of epilepsy patients. (C) 2020 Elsevier Inc. All rights reserved.
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页数:7
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