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Decreased income, unemployment, and disability after craniotomy for brain tumor removal: a South Korean nationwide cohort study

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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).

Code availability

Not applicable.

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Authors and Affiliations

Authors

Contributions

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.

Corresponding author

Correspondence to Young-Tae Jeon.

Ethics declarations

Additional declarations for articles in life science journals that report the results of studies involving humans and/or animals.

Not applicable.

Ethics approval

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).

Consent to participate

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.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

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Supplementary Information

Below is the link to the electronic supplementary material.

eTable 1. The ICD-10 codes used by comorbidity to compute the Charlson comorbidity index. (DOCX 17 KB)

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)

High resolution image (TIF 1313 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

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