Silvia Schiavolin1, Arianna Mariniello2, Morgan Broggi3, Francesco DiMeco3, Paolo Ferroli3, Matilde Leonardi2. 1. Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. silvia.schiavolin@istituto-besta.it. 2. Neurology, Public Health and Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy. 3. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
Abstract
PURPOSE: To identify the preoperative nonmedical predictors of functional impairment after brain tumor surgery. METHODS: Patients were evaluated before brain tumor surgery and after 3 months. The cognitive evaluation included MOCA for the general cognitive status, TMT for attention and executive functions, ROWL-IR and ROWL-DR for memory, and the F-A-S for verbal fluency. Anxiety, depression, social support, resilience, personality, disability, and quality of life were evaluated with the following patient-reported outcome measures (PROMs): HADS, OSS-3, RS-14, TIPI, WHODAS-12, and EORTC-QLQ C30. Functional status was measured with KPS. Regression analyses were performed to identify preoperative nonmedical predictors of functional impairment; PROMs and cognitive tests were compared with the normative values. RESULTS: A total of 149 patients were enrolled (64 glioma; 85 meningioma). Increasing age, lower education, higher disability, and lower ROWL-DR scores were predictors of functional impairment in glioma patients while higher TMT scores and disability were predictors in meningioma patients. In multiple regression, only a worse performance in TMT remains a predictor in meningioma patients. Cognitive tests were not significantly worse than normative values, while psychosocial functioning was impaired. CONCLUSION: TMT could be used in the preoperative evaluation and as a potential predictor in the research field on outcome predictors. Psychosocial functioning should be studied further and considered in a clinical context to identify who need major support and to plan tailored interventions.
PURPOSE: To identify the preoperative nonmedical predictors of functional impairment after brain tumor surgery. METHODS: Patients were evaluated before brain tumor surgery and after 3 months. The cognitive evaluation included MOCA for the general cognitive status, TMT for attention and executive functions, ROWL-IR and ROWL-DR for memory, and the F-A-S for verbal fluency. Anxiety, depression, social support, resilience, personality, disability, and quality of life were evaluated with the following patient-reported outcome measures (PROMs): HADS, OSS-3, RS-14, TIPI, WHODAS-12, and EORTC-QLQ C30. Functional status was measured with KPS. Regression analyses were performed to identify preoperative nonmedical predictors of functional impairment; PROMs and cognitive tests were compared with the normative values. RESULTS: A total of 149 patients were enrolled (64 glioma; 85 meningioma). Increasing age, lower education, higher disability, and lower ROWL-DR scores were predictors of functional impairment in glioma patients while higher TMT scores and disability were predictors in meningioma patients. In multiple regression, only a worse performance in TMT remains a predictor in meningioma patients. Cognitive tests were not significantly worse than normative values, while psychosocial functioning was impaired. CONCLUSION: TMT could be used in the preoperative evaluation and as a potential predictor in the research field on outcome predictors. Psychosocial functioning should be studied further and considered in a clinical context to identify who need major support and to plan tailored interventions.
Authors: Paolo Ferroli; Morgan Broggi; Silvia Schiavolin; Francesco Acerbi; Valentina Bettamio; Dario Caldiroli; Alberto Cusin; Emanuele La Corte; Matilde Leonardi; Alberto Raggi; Marco Schiariti; Sergio Visintini; Angelo Franzini; Giovanni Broggi Journal: Neurosurg Focus Date: 2015-12 Impact factor: 4.047
Authors: Joeky T Senders; Patrick C Staples; Aditya V Karhade; Mark M Zaki; William B Gormley; Marike L D Broekman; Timothy R Smith; Omar Arnaout Journal: World Neurosurg Date: 2017-10-03 Impact factor: 2.104