PURPOSE We aimed to investigate the prevalence of quality-of-life deterioration and associated factors in patients who underwent craniotomies for brain tumor removal. Additionally, we examined whether deteriorating quality of life after surgery might affect mortality. METHODS As a national population-based cohort study, data were extracted from the National Health Insurance Service database of South Korea. Adult patients (≥ 18 years old) who underwent craniotomy for excision of brain tumors after diagnosis of malignant brain tumor between January 1, 2011, and December 31, 2017, were included in this study. RESULTS A total of 4852 patients were included in the analysis. Among them, 2273 patients (46.9%) experienced a deterioration in quality of life after surgery. Specifically, 595 (12.3%) lost their jobs, 1329 (27.4%) experienced decreased income, and 844 (17.4%) patients had newly acquired disabilities. In the multivariable Cox regression model, a lower quality of life was associated with a 1.41-fold higher 2-year all-cause mortality (hazard ratio: 1.41, 95% confidence interval: 1.27-1.57; P < 0.001). Specifically, newly acquired disability was associated with 1.80-fold higher 2-year all-cause mortality (hazard ratio: 1.80, 95% confidence interval: 1.59-2.03; P < 0.001), while loss of job (P = 0.353) and decreased income (P = 0.599) were not significantly associated. CONCLUSIONS At 1-year follow-up, approximately half the patients who participated in this study experienced a deterioration in the quality-of-life measures of unemployment, decreased income, and newly acquired disability after craniotomy for excision of brain tumors. Newly acquired disability was associated with increased 2-year all-cause mortality.

中文翻译：

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开颅切除脑肿瘤后收入、失业和残疾减少：韩国全国队列研究。

目的 我们旨在调查接受颅骨切开术切除脑肿瘤的患者生活质量恶化的发生率和相关因素。此外，我们检查了手术后生活质量的恶化是否会影响死亡率。方法 作为一项基于全国人口的队列研究，数据来自韩国国民健康保险服务数据库。本研究纳入2011年1月1日至2017年12月31日诊断为恶性脑瘤后接受开颅手术切除脑瘤的成年患者（≥18岁）。结果 共有 4852 名患者被纳入分析。其中，2273例（46.9%）患者术后生活质量出现恶化。具体而言，595 人（12.3%）失业，1329 人（27. 4%) 经历了收入下降，844 名 (17.4%) 患者出现了新获得的残疾。在多变量 Cox 回归模型中，较低的生活质量与 1.41 倍的 2 年全因死亡率相关（风险比：1.41，95% 置信区间：1.27-1.57；P < 0.001）。具体而言，新获得的残疾与 2 年全因死亡率增加 1.80 倍相关（风险比：1.80，95% 置信区间：1.59-2.03；P < 0.001），而失业（P = 0.353）并下降收入（P = 0.599）没有显着相关性。结论 在 1 年的随访中，大约一半参与本研究的患者在开颅切除脑肿瘤后经历了失业、收入下降和新获得性残疾等生活质量指标的恶化。