Purpose

Long-term impairment of quality of life (QoL) occurs in a subset of meningioma patients, even after curative surgical resection. We sought to explore socioeconomic burden of meningioma surgery and associations with post-operative QoL to identify patients at risk for inferior outcome.

Methods

All patients with histological diagnosis of an intracranial meningioma treated at a single institution 2000–2013 were screened for inclusion in this cross-sectional survey study. Surveys comprised tools to assess socioeconomic status including social deprivation, QoL and symptom burden. Multivariate binary regression models controlling for established prognostic factors were applied to explore associations of socioeconomics with QoL 1 year after surgery.

Results

Completed surveys were returned by 249 patients. The median age at diagnosis was 56 years (SD ± 12), 185 patients (74%) were female and 219 (88%) had World Health Organization grade I meningiomas. One year after surgery, there was a 20% decrease in the number of patients working (p < 0.001), 22% of full-time working patients transitioned to part-time work (p < 0.001) and more patients depended on professional care (14% versus 4%, p < 0.001). Patients reported improved QoL, including improved global health (effect: 21%, 95% confidence interval [1] 15–26%), headaches (effect: 19%, CI 13–24%) and seizures (effect: 12%, CI 8–17%). On multivariable analyses, QoL after meningioma surgery was associated with preoperative employment status (odds ratio [OR] 0.41, 95% CI 0.17–0.98) and subjective work ability (OR 0.37, 95% CI 0.15–0.92).

Conclusion

In a subset of meningioma patients, there is marked socioeconomic burden, which may be associated with inferior patient-reported outcome.

中文翻译：

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脑膜瘤患者的社会经济负担和生活质量。

目的

即使在治愈性手术切除后，一部分脑膜瘤患者也会发生长期生活质量（QoL）损害。我们试图探讨脑膜瘤手术的社会经济负担以及与术后QoL的关联，以识别有不良后果风险的患者。

方法

筛选所有在2000-2013年接受单一组织治疗的颅内脑膜瘤组织学诊断的患者，以纳入本横断面调查研究。调查包括评估社会经济状况的工具，包括社会剥夺，生活质量和症状负担。应用控制已建立的预后因素的多元二元回归模型探讨术后1年的社会经济学与QoL的关联。

结果

249位患者返回了完成的调查。诊断时的中位年龄为56岁（SD±12），其中185例（74％）为女性，219例（88％）为世界卫生组织I级脑膜瘤。手术后一年，工作的患者人数减少了20％（p  <0.001），全职工作的患者有22％转变为兼职（p  <0.001），更多的患者依赖专业护理（ 14％对4％，p <0.001）。患者报告的QoL改善，包括整体健康状况改善（效果：21％，95％置信区间[1] 15–26％），头痛（效果：19％，CI 13-24％）和癫痫发作（效果：12％，CI） 8–17％）。在多变量分析中，脑膜瘤手术后的生活质量与术前就业状况（赔率[OR] 0.41，95％CI 0.17-0.98）和主观工作能力（OR 0.37，95％CI 0.15-0.92）相关。

结论

在一部分脑膜瘤患者中，存在明显的社会经济负担，这可能与患者报告的不良结果有关。