Health‐related quality of life, mood, and patient satisfaction after epilepsy surgery in Sweden—A prospective controlled observational study. Issue 6 (4th April 2014)

• Record Type: Journal Article
• Authors: Taft, Charles; Sager Magnusson, Elisabet; Ekstedt, Gerd; Malmgren, Kristina
• Is Part Of: Epilepsia. Volume 55:Issue 6(2014:Jun.)
• Page Start: 878
• Page End: 885
• Publication Date: 2014-04-04
• Subjects: Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.12616
• Languages: English
• ISSNs: 0013-9580

Abstract

<abstract abstract-type="main" id="epi12616-abs-0001"> <title>Summary</title> <sec id="epi12616-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate health‐related quality of life (HRQOL), mood, and patient satisfaction in epilepsy surgery candidates before and 2 years after epilepsy surgery or presurgical investigation.</p> </sec> <sec id="epi12616-sec-0002" sec-type="section"> <title>Methods</title> <p>In this prospective study of 141 patients, 96 underwent surgery and 45 did not. Questionnaires at baseline and at 2‐year follow‐up included the generic 36‐item Short Form Health Survey (SF‐36), the Hospital Anxiety and Depression scale (HAD), and operated patients answered patient satisfaction questions. SF‐36 scores were compared with scores from a matched sample from the Swedish norm population. Numbers were calculated of patients achieving a minimum important change (MIC) in the SF‐36 Physical Composite Summary (PCS) and Mental Composite Summary (MCS).</p> </sec> <sec id="epi12616-sec-0003" sec-type="section"> <title>Results</title> <p>At baseline, patients had significantly lower values than the norm on all SF‐36 domains. At follow‐up, operated patients were divided into seizure‐free (International League Against Epilepsy [ILAE] class 1 and 2, n = 53) or with continued seizures (n = 43). No differences in baseline HAD or SF‐36 values were found between these groups. Seizure‐free patients reached the same levels as the norm in all SF‐36 domains except Social Function. Operated patients with continued seizures and nonoperated patients had unchanged scores. Fifty‐one percent of seizure‐free patients had an improvement reaching MIC for PCS and 45% for MCS. Corresponding results for patients with continued seizures were 28% in PCS and 28% in MCS, for nonoperated 33% in PCS and 29% in MCS. HAD anxiety scores improved significantly in only the seizure‐free patients. Of all operated patients, 80% were satisfied with having had surgery and 86% considered that they had benefited, whereas 20% thought that surgery caused some harm.</p> </sec> <sec id="epi12616-sec-0004" sec-type="section"> <title>Significance</title> <p>In patients who were seizure‐free after epilepsy surgery HRQOL normalized and anxiety decreased. Operated patients overwhelmingly considered epilepsy surgery to be beneficial. Nonetheless, only about half of the seizure‐free patients achieved important HRQOL improvements, suggesting that seizure freedom does not in and of itself guarantee improved patient well‐being.</p> <p>A PowerPoint slide summarizing this article is available for download in the Supporting Information section <ext-link ext-link-type="uri" xlink:href="http://onlinelibrary.wiley.com/doi/10.1111/epi.12616/supinfo" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink">here</ext-link>.</p> </sec> </abstract>