Journal article 674 views 194 downloads
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data
Epilepsy & Behavior, Volume: 111, Start page: 107196
Swansea University Authors:
Owen Pickrell , Arron S. Lacey
, Mark Rees
-
PDF | Accepted Manuscript
Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND).
Download (347.2KB)
DOI (Published version): 10.1016/j.yebeh.2020.107196
Abstract
Objective: The objective of the study was to assess the long-term outcomes of epilepsy surgery between 1995 and 2015 in South Wales, UK, linking case note review, postal questionnaire, and routinely collected healthcare data.Method: We identified patients from a departmental database and collected o...
Published in: | Epilepsy & Behavior |
---|---|
ISSN: | 1525-5050 |
Published: |
Elsevier BV
2020
|
Online Access: |
Check full text
|
URI: | https://cronfa.swan.ac.uk/Record/cronfa54431 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
first_indexed |
2020-06-10T19:08:17Z |
---|---|
last_indexed |
2023-01-11T14:32:28Z |
id |
cronfa54431 |
recordtype |
SURis |
fullrecord |
<?xml version="1.0"?><rfc1807><datestamp>2022-12-05T12:55:44.3230116</datestamp><bib-version>v2</bib-version><id>54431</id><entry>2020-06-10</entry><title>Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data</title><swanseaauthors><author><sid>1c3044b5ff7a6552ff5e8c9e3901c807</sid><ORCID>0000-0003-4396-5657</ORCID><firstname>Owen</firstname><surname>Pickrell</surname><name>Owen Pickrell</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>7af5c8bdd1197f85720e4f3d65e803eb</sid><ORCID>0000-0001-7983-8073</ORCID><firstname>Arron S.</firstname><surname>Lacey</surname><name>Arron S. Lacey</name><active>true</active><ethesisStudent>true</ethesisStudent></author><author><sid>10f39a4e9c2ee00d453cd84c10667ac8</sid><ORCID/><firstname>Mark</firstname><surname>Rees</surname><name>Mark Rees</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2020-06-10</date><deptcode>FGMHL</deptcode><abstract>Objective: The objective of the study was to assess the long-term outcomes of epilepsy surgery between 1995 and 2015 in South Wales, UK, linking case note review, postal questionnaire, and routinely collected healthcare data.Method: We identified patients from a departmental database and collected outcome data from patient case notes, a postal questionnaire, and the QOLIE-31-P and linked with Welsh routinely collected data in the Secure Anonymised Information Linkage (SAIL) databank.Results: Fifty-seven patients were included. Median age at surgery was 34 years (11-70), median: 24 years (2-56) after onset of habitual seizures. Median follow-up was 7 years (2-19). Twenty-eight (49%) patients were free from disabling seizures (Engel Class 1), 9 (16%) experienced rare disabling seizures (Class 2), 13 (23%) had worthwhile improvements (Class 3), and 7 (12%) had no improvement (Class 4). There was a 30% mean reduction in total antiepileptic drug (AED) load at five years postsurgery. Thirty-eight (66.7%) patients experienced tonic-clonic seizures presurgery verses 8 (14%) at last review. Seizure-free patients self-reported a greater overall quality of life (QOL; QOLIE-31-P) when compared with those not achieving seizure freedom. Seizure-free individuals scored a mean of 67.6/100 (100 is best), whereas those with continuing seizures scored 46.0/100 (p < 0.006). There was a significant decrease in the median rate of hospital admissions for any cause after epilepsy surgery (9.8 days per 1000 patient days before surgery compared with 3.9 after p < 0.005).Significance: Epilepsy surgery was associated with significant improvements in seizures, a reduced AED load, and an improved QOL that closely correlated with seizure outcomes and reduced hospital admission rates following surgery. Despite this, there was a long delay from onset of habitual seizures to surgery. The importance of long-term follow-up is emphasized in terms of evolving medical needs and health and social care outcomes.</abstract><type>Journal Article</type><journal>Epilepsy & Behavior</journal><volume>111</volume><journalNumber/><paginationStart>107196</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1525-5050</issnPrint><issnElectronic/><keywords>Refractory epilepsy; Epilepsy surgery; Seizure cessation; Quality of life; Long-term outcomes</keywords><publishedDay>1</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2020</publishedYear><publishedDate>2020-10-01</publishedDate><doi>10.1016/j.yebeh.2020.107196</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2022-12-05T12:55:44.3230116</lastEdited><Created>2020-06-10T16:06:54.0852237</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Bengi</firstname><surname>Kansu</surname><order>1</order></author><author><firstname>Owen</firstname><surname>Pickrell</surname><orcid>0000-0003-4396-5657</orcid><order>2</order></author><author><firstname>Arron S.</firstname><surname>Lacey</surname><orcid>0000-0001-7983-8073</orcid><order>3</order></author><author><firstname>Ffion</firstname><surname>Edwards</surname><order>4</order></author><author><firstname>Georgiana</firstname><surname>Samolia</surname><order>5</order></author><author><firstname>Mark</firstname><surname>Rees</surname><orcid/><order>6</order></author><author><firstname>Robert</firstname><surname>Elwes</surname><order>7</order></author><author><firstname>Richard</firstname><surname>Hatfield</surname><order>8</order></author><author><firstname>William</firstname><surname>Gray</surname><order>9</order></author><author><firstname>Khalid</firstname><surname>Hamandi</surname><order>10</order></author></authors><documents><document><filename>54431__17581__158937c9323541589d7af7dbafa1672d.pdf</filename><originalFilename>54431.pdf</originalFilename><uploaded>2020-06-26T09:15:18.0608469</uploaded><type>Output</type><contentLength>355531</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2021-06-15T00:00:00.0000000</embargoDate><documentNotes>Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND).</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807> |
spelling |
2022-12-05T12:55:44.3230116 v2 54431 2020-06-10 Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data 1c3044b5ff7a6552ff5e8c9e3901c807 0000-0003-4396-5657 Owen Pickrell Owen Pickrell true false 7af5c8bdd1197f85720e4f3d65e803eb 0000-0001-7983-8073 Arron S. Lacey Arron S. Lacey true true 10f39a4e9c2ee00d453cd84c10667ac8 Mark Rees Mark Rees true false 2020-06-10 FGMHL Objective: The objective of the study was to assess the long-term outcomes of epilepsy surgery between 1995 and 2015 in South Wales, UK, linking case note review, postal questionnaire, and routinely collected healthcare data.Method: We identified patients from a departmental database and collected outcome data from patient case notes, a postal questionnaire, and the QOLIE-31-P and linked with Welsh routinely collected data in the Secure Anonymised Information Linkage (SAIL) databank.Results: Fifty-seven patients were included. Median age at surgery was 34 years (11-70), median: 24 years (2-56) after onset of habitual seizures. Median follow-up was 7 years (2-19). Twenty-eight (49%) patients were free from disabling seizures (Engel Class 1), 9 (16%) experienced rare disabling seizures (Class 2), 13 (23%) had worthwhile improvements (Class 3), and 7 (12%) had no improvement (Class 4). There was a 30% mean reduction in total antiepileptic drug (AED) load at five years postsurgery. Thirty-eight (66.7%) patients experienced tonic-clonic seizures presurgery verses 8 (14%) at last review. Seizure-free patients self-reported a greater overall quality of life (QOL; QOLIE-31-P) when compared with those not achieving seizure freedom. Seizure-free individuals scored a mean of 67.6/100 (100 is best), whereas those with continuing seizures scored 46.0/100 (p < 0.006). There was a significant decrease in the median rate of hospital admissions for any cause after epilepsy surgery (9.8 days per 1000 patient days before surgery compared with 3.9 after p < 0.005).Significance: Epilepsy surgery was associated with significant improvements in seizures, a reduced AED load, and an improved QOL that closely correlated with seizure outcomes and reduced hospital admission rates following surgery. Despite this, there was a long delay from onset of habitual seizures to surgery. The importance of long-term follow-up is emphasized in terms of evolving medical needs and health and social care outcomes. Journal Article Epilepsy & Behavior 111 107196 Elsevier BV 1525-5050 Refractory epilepsy; Epilepsy surgery; Seizure cessation; Quality of life; Long-term outcomes 1 10 2020 2020-10-01 10.1016/j.yebeh.2020.107196 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2022-12-05T12:55:44.3230116 2020-06-10T16:06:54.0852237 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Bengi Kansu 1 Owen Pickrell 0000-0003-4396-5657 2 Arron S. Lacey 0000-0001-7983-8073 3 Ffion Edwards 4 Georgiana Samolia 5 Mark Rees 6 Robert Elwes 7 Richard Hatfield 8 William Gray 9 Khalid Hamandi 10 54431__17581__158937c9323541589d7af7dbafa1672d.pdf 54431.pdf 2020-06-26T09:15:18.0608469 Output 355531 application/pdf Accepted Manuscript true 2021-06-15T00:00:00.0000000 Released under the terms of a Creative Commons Attribution Non-Commercial No Derivatives License (CC-BY-NC-ND). true eng |
title |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
spellingShingle |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data Owen Pickrell Arron S. Lacey Mark Rees |
title_short |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
title_full |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
title_fullStr |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
title_full_unstemmed |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
title_sort |
Long-term outcomes after epilepsy surgery, a retrospective cohort study linking patient-reported outcomes and routine healthcare data |
author_id_str_mv |
1c3044b5ff7a6552ff5e8c9e3901c807 7af5c8bdd1197f85720e4f3d65e803eb 10f39a4e9c2ee00d453cd84c10667ac8 |
author_id_fullname_str_mv |
1c3044b5ff7a6552ff5e8c9e3901c807_***_Owen Pickrell 7af5c8bdd1197f85720e4f3d65e803eb_***_Arron S. Lacey 10f39a4e9c2ee00d453cd84c10667ac8_***_Mark Rees |
author |
Owen Pickrell Arron S. Lacey Mark Rees |
author2 |
Bengi Kansu Owen Pickrell Arron S. Lacey Ffion Edwards Georgiana Samolia Mark Rees Robert Elwes Richard Hatfield William Gray Khalid Hamandi |
format |
Journal article |
container_title |
Epilepsy & Behavior |
container_volume |
111 |
container_start_page |
107196 |
publishDate |
2020 |
institution |
Swansea University |
issn |
1525-5050 |
doi_str_mv |
10.1016/j.yebeh.2020.107196 |
publisher |
Elsevier BV |
college_str |
Faculty of Medicine, Health and Life Sciences |
hierarchytype |
|
hierarchy_top_id |
facultyofmedicinehealthandlifesciences |
hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
department_str |
Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
document_store_str |
1 |
active_str |
0 |
description |
Objective: The objective of the study was to assess the long-term outcomes of epilepsy surgery between 1995 and 2015 in South Wales, UK, linking case note review, postal questionnaire, and routinely collected healthcare data.Method: We identified patients from a departmental database and collected outcome data from patient case notes, a postal questionnaire, and the QOLIE-31-P and linked with Welsh routinely collected data in the Secure Anonymised Information Linkage (SAIL) databank.Results: Fifty-seven patients were included. Median age at surgery was 34 years (11-70), median: 24 years (2-56) after onset of habitual seizures. Median follow-up was 7 years (2-19). Twenty-eight (49%) patients were free from disabling seizures (Engel Class 1), 9 (16%) experienced rare disabling seizures (Class 2), 13 (23%) had worthwhile improvements (Class 3), and 7 (12%) had no improvement (Class 4). There was a 30% mean reduction in total antiepileptic drug (AED) load at five years postsurgery. Thirty-eight (66.7%) patients experienced tonic-clonic seizures presurgery verses 8 (14%) at last review. Seizure-free patients self-reported a greater overall quality of life (QOL; QOLIE-31-P) when compared with those not achieving seizure freedom. Seizure-free individuals scored a mean of 67.6/100 (100 is best), whereas those with continuing seizures scored 46.0/100 (p < 0.006). There was a significant decrease in the median rate of hospital admissions for any cause after epilepsy surgery (9.8 days per 1000 patient days before surgery compared with 3.9 after p < 0.005).Significance: Epilepsy surgery was associated with significant improvements in seizures, a reduced AED load, and an improved QOL that closely correlated with seizure outcomes and reduced hospital admission rates following surgery. Despite this, there was a long delay from onset of habitual seizures to surgery. The importance of long-term follow-up is emphasized in terms of evolving medical needs and health and social care outcomes. |
published_date |
2020-10-01T04:07:58Z |
_version_ |
1763753568086523904 |
score |
11.021648 |