Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study
Quality of life
Adult
Male
Drug Resistant Epilepsy
Psychometrics
Hippocampus
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Epilepsy surgery
Outcome Assessment, Health Care
Humans
Prospective Studies
Depressive Disorder
Sclerosis
Predictors
Mesial temporal lobe epilepsy
Anterior Temporal Lobectomy
3. Good health
Epilepsy, Temporal Lobe
Quality of Life
Female
Follow-Up Studies
DOI:
10.1111/epi.13721
Publication Date:
2017-03-24T06:46:15Z
AUTHORS (15)
ABSTRACT
SummaryObjectivesTo investigate prospectively the independent predictors of a minimum clinically important change (MCIC) in quality of life (QOL) after anterior temporal lobectomy (ATL) for drug‐resistant mesial temporal lobe epilepsy related to hippocampal sclerosis (MTLE‐HS) in Brazilian patients.MethodsMultiple binary logistic regression analysis was performed to identify the clinical, demographic, radiologic, and electrophysiologic variables independently associated with MCIC in the Quality of Life in Epilepsy‐31 Inventory (QOLIE‐31) overall score 1 year after ATL in 77 consecutive patients with unilateral MTLE‐HS.ResultsThe overall QOLIE‐31 score and all its subscale scores increased significantly (p < 0.0001) 1 year after ATL. In the final logistic regression model, absence of presurgical diagnosis of depression (adjusted odds ratio [OR] 4.4, 95% confidence interval [CI] 1.1–16.1, p = 0.02) and a complete postoperative seizure control (adjusted OR 4.1, 95% CI 1.2–14.5, p = 0.03) were independently associated with improvement equal to or greater than the MCIC in QOL after ATL. The overall model accuracy for MCIC improvement in the QOL was 85.6%, with a 95.2% of sensitivity and 46.7% of specificity.SignificanceThese results in Brazilian patients reinforce the external validation of previous findings in Canadian patients showing that presurgical depression and complete seizure control after surgery are independent predictors for meaningful improvement in QOL after ATL, and have implications for the surgical management of MTLE patients.
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