Health-related quality of life in patients with untreated cavernous malformations of the central nervous system

A Herten; B Chen; D Saban; A Santos; K Wrede; R Jabbarli; Y Zhu; B Schmidt; C Kleinschnitz; M Forsting; U Sure; P Dammann

doi:10.1111/ene.14546

Health-related quality of life in patients with untreated cavernous malformations of the central nervous system

Eur J Neurol. 2021 Feb;28(2):491-499. doi: 10.1111/ene.14546. Epub 2020 Oct 24.

Authors

A Herten¹, B Chen¹, D Saban¹, A Santos¹, K Wrede¹, R Jabbarli¹, Y Zhu¹, B Schmidt², C Kleinschnitz³, M Forsting⁴, U Sure¹, P Dammann¹

Affiliations

¹ Department of Neurosurgery, University Hospital Essen, Essen, Germany.
² Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany.
³ Department of Neurology, University Hospital Essen, Essen, Germany.
⁴ Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.

PMID: 32961598
DOI: 10.1111/ene.14546

Abstract

Background and purpose: To estimate health-related quality of life (HRQOL) in patients with untreated cavernous malformation of the CNS [cavernous cerebral malformations (CCMs)].

Methods: We performed a cross-sectional observational study on patients with CCMs admitted to our department from 1 November 2017 to 10 January 2020 using standardized interviews [short-form-36 questionnaire, hospital anxiety and depression score (HADS-A/D), CCM perception questionnaire]. Included criteria were diagnosis of an untreated CCM and information about the diagnosis in a specialized CCM consultation. Health-related quality of life (HRQOL) data were analyzed and compared to the German normal population. Uni- and multivariate analyses were carried out to identify variables with impact on outcome.

Results: Two hundred nineteen (93%) of 229 eligible patients were included. Mean age was 46.3 ± 14.7 (18-86) years; 136 (62%) were female. Ninety-eight (45%) patients presented with symptomatic hemorrhage (SH), and 17 (8%) with repetitive SH. Ninety-two (42%) patients were asymptomatic. Thirty-seven patients (17%) suffered from cavernoma-related epilepsy. Twenty-eight patients (13%) suffered from familial CCMs. Patients showed significantly decreased component scores and subdomain scores compared to the normal population, with effects ranging from small to large. This accounted largely also for asymptomatic patients (except for physical component score and main physical subdomains). Multivariate regression analysis confirmed impact of functional impairment on physical component score. HADS-A was significantly increased. HADS-A/D strongly correlated with mental component score and individual perception of the CCM.

Conclusions: Patients with the diagnosis of a CCM showed decreased HRQOL compared to the normal population even when not suffering functional impairment or neurological symptoms. Our data may function as benchmarks in evaluation of different (future) management strategies.

Keywords: anxiety; depression; quality of life; untreated cavernous malformation.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety
Central Nervous System
Cross-Sectional Studies
Female
Hemangioma, Cavernous, Central Nervous System*
Humans
Middle Aged
Quality of Life*