Pre-Operative Predictors of Health-Related Quality of Life Two Years After Pediatric Epilepsy Surgery: A Prospective Cohort Study.

Health-related quality of life Pediatric epilepsy surgery Predictors

Journal

Seizure
ISSN: 1532-2688
Titre abrégé: Seizure
Pays: England
ID NLM: 9306979

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 14 07 2023
revised: 28 08 2023
accepted: 31 08 2023
pubmed: 9 9 2023
medline: 9 9 2023
entrez: 8 9 2023
Statut: ppublish

Résumé

Seizure freedom is an important predictor of health-related quality of life (HRQOL) after pediatric epilepsy surgery. This study aimed to identify the pre-operative predictors of HRQOL 2 years after epilepsy surgery in children with drug-resistant epilepsy. This multicenter prospective cohort study assessed pre-operative predictors including child (demographics and clinical variables), caregiver (including caregiver depressive and anxiety symptoms) and family characteristics. HRQOL was assessed using the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE)-55 pre-operatively and 2-years after surgery. Univariable linear regression analyses were done to identify significant preoperative predictors of HRQOL 2-years after surgery, followed by multivariable regression. Ninety-five children underwent surgery, mean age was 11.4 (SD=4.2) years, and 59 (62%) were male. Mean QOLCE scores were 57.4 (95%CI: 53.8, 61.0) pre-operatively and 65.6 (95%CI: 62.0, 69.1) after surgery. Univariable regression showed fewer anti-seizure medications (ß=-6.1 [95%CI: -11.2, -1.0], p = 0.019), older age at seizure onset (ß=1.6 [95%CI: 0.8, 2.4], p<0.001), higher pre-operative HRQOL (ß=0.7 [95%CI: 0.5, 0.8], p<0.001), higher family resources (ß=0.6 [95%CI: 0.3, 0.9], p<0.001), better family relationships (ß=1.7 [95%CI: 0.3, 3.1], p = 0.017) and lower family demands (ß=-0.9 [95%CI: -1.5, -0.4], p<0.001) were associated with higher HRQOL after surgery. Caregiver characteristics did not predict HRQOL after surgery (p>0.05). Multivariable regression showed older age at seizure onset (ß=4.6 [95%CI: 1.6, 7.6], p = 0.003) and higher pre-operative HRQOL (ß=10.2 [95%CI: 6.8, 13.6], p<0.001) were associated with higher HRQOL after surgery. This study underscores the importance of optimizing pre-operative HRQOL to maximize HRQOL outcome after pediatric epilepsy surgery.

Identifiants

DOI: 10.1016/j.seizure.2023.08.016 PMID: 37683452
pubmed: 37683452
pii: S1059-1311(23)00231-5
doi: 10.1016/j.seizure.2023.08.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

196-202

Informations de copyright

Copyright © 2023 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Krishna Vamsi Rojulpote (KV)

Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.

Mary Lou Smith (ML)

Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada; Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada.

Klajdi Puka (K)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Kathy N Speechley (KN)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Mark A Ferro (MA)

School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.

Mary B Connolly (MB)

Division of Neurology, Department of Pediatrics, BC Children's Hospital, Vancouver, BC, Canada.

Philippe Major (P)

Division of Neurology, Department of Neurosciences, CHU Ste-Justine Hospital, University of Montreal, QC, Canada.

Anne Gallagher (A)

Centre de Recherche, CHU Ste-Justine Hospital, University of Montreal, QC, Canada.

Salah Almubarak (S)

Division of Pediatric Neurology, Department of Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada; Qatif Central Hospital, Qatif, Saudi Arabia.

Simona Hasal (S)

Division of Pediatric Neurology, Department of Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada.

Rajesh Ramachandrannair (R)

Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

Andrea Andrade (A)

Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Qi Xu (Q)

Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.

Edward Leung (E)

Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada.

O Carter Snead (OC)

Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.

Elysa Widjaja (E)

Neurosciences and Mental Health Program, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, Lurie Children's Hospital, Chicago, IL, USA. Electronic address: ewidjaja@luriechildrens.org.

Classifications MeSH