Predictors of Improvement in Quality of Life at 12-month Follow-up in Patients Undergoing Anterior Endoscopic Skull Base Surgery

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2022 Jul 27

PMID 35895728

Authors

Quinlan D Buchlak

Nazanin Esmaili

Christine Bennett

Yi Yuen Wang

James King

Tony Goldschlager

Affiliations

Soon will be listed here.

Abstract

Background: Patients with pituitary lesions experience decrements in quality of life (QoL) and treatment aims to arrest or improve QoL decline.

Objective: To detect associations with QoL in trans-nasal endoscopic skull base surgery patients and train supervised learning classifiers to predict QoL improvement at 12 months.

Methods: A supervised learning analysis of a prospective multi-institutional dataset (451 patients) was conducted. QoL was measured using the anterior skull base surgery questionnaire (ASBS). Factors associated with QoL at baseline and at 12-month follow-up were identified using multivariate logistic regression. Multiple supervised learning models were trained to predict postoperative QoL improvement with five-fold cross-validation.

Results: ASBS at 12-month follow-up was significantly higher (132.19,SD = 24.87) than preoperative ASBS (121.87,SD = 25.72,p<0.05). High preoperative scores were significantly associated with institution, diabetes and lesions at the planum sphenoidale / tuberculum sella site. Patients with diabetes were five times less likely to report high preoperative QoL. Low preoperative QoL was significantly associated with female gender, a vision-related presentation, diabetes, secreting adenoma and the cavernous sinus site. Top quartile change in postoperative QoL at 12-month follow-up was negatively associated with baseline hypercholesterolemia, acromegaly and intraoperative CSF leak. Positive associations were detected for lesions at the sphenoid sinus site and deficient preoperative endocrine function. AdaBoost, logistic regression and neural network classifiers yielded the strongest predictive performance.

Conclusion: It was possible to predict postoperative positive change in QoL at 12-month follow-up using perioperative data. Further development and implementation of these models may facilitate improvements in informed consent, treatment decision-making and patient QoL.

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