A patient assessed morbidity to evaluate outcome in surgically treated vestibular schwannomas.

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A patient assessed morbidity to evaluate outcome in surgically treated vestibular schwannomas.

World Neurosurg. 2016 Jul 18;

Authors: Al-Shudifat AR, Kahlon B, Höglund P, Lindberg S, Magnusson M, Siesjo P

Abstract
OBJECTIVE: Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance and morbidity. As mortality and recurrence are rare events evaluation has to focus on performance and morbidity. The latters have mostly been reported by health providers. In the present study we validate two new scales for patient assessed performance and morbidity in comparison with different outcome tools as QOL (EQ5D), facial nerve score and work capacity.
METHODS: 167 patients in a retrospective (n=90) and a prospective (n=50) cohort of surgically treated vestibular schwannomas were studied. A new patient assessed morbidity score (paMS), a patient assessed Karnofsky score (paKPS), the patient assessed QOL (EQ-5D) score, work capacity and House Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes were done in uni- and multivariate analysis.
RESULTS: All outcome instruments except EQ5D and paKPS showed a significant decrease postoperatively. Only the facial nerve score (HB) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the patient assessed morbidity score hearing dysfunction, tear dysfunction, balance dysfunction and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly to work capacity.
CONCLUSIONS: Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery.

PMID: 27443231 [PubMed - as supplied by publisher]

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