Abstract
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.
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Availability of data and material
The data that support the findings of this study are available from National Health Insurance System, but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission from the National Health Insurance System (https://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do). If someone wants to request the data from this study, please contact to corresponding author (ytjeon@snubh.org).
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TKO and YTJ contributed to the study design, analyzed the data, and drafted the first manuscript. IAS, SYL, HYC, and JYK contributed to the data acquisition and critically revised the manuscript. All authors read and approved the final version of the manuscript.
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The study protocol was approved by the Institutional Review Board of Seoul National University Bundang Hospital (approval number: X-2104–679-901), and the National Health Insurance Service (NHIS) approved our study’s data provision protocol (approval number: NHIS-2020–1-306).
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The need for informed consent was waived by the Institutional Review Board because the data were retrospectively analyzed using anonymized data from the NHIS database.
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520_2021_6575_MOESM2_ESM.docx
eTable 2. Other covariates in the multivariable model 1 (Table 4). (DOCX 18 KB)
eFigure 1
Survival plot derived from the multivariable model. (PNG128 kb)
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Oh, T.K., Song, IA., Kwon, JE. et al. Decreased income, unemployment, and disability after craniotomy for brain tumor removal: a South Korean nationwide cohort study. Support Care Cancer 30, 1663–1671 (2022). https://doi.org/10.1007/s00520-021-06575-1
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DOI: https://doi.org/10.1007/s00520-021-06575-1