210. PedsQL For Prediction Of Postoperative Patient-Reported Outcomes Following Chiari Decompression Surgery

Authors: Andrew H. Jea, MD, FAANS; Shawyon Baygani, BS; Kristin Zieles, BS; Andrew Jea (Indianapolis, IN)

OBJECTIVE

The purpose of this study is to determine if the preoperative PedsQL score is predictive of short- and intermediate-term PedsQL outcomes following Chiari decompression surgery. To our knowledge, there is no widely accepted tool up to this point to predict short-, intermediate-, or long-term outcomes after pediatric Chiari decompression surgery.

 METHODS

A prospectively maintained database was retrospectively reviewed. Patients who underwent first-time decompression for symptomatic Chiari malformation were identified.  PedsQL outcomes were collected at 6-week, 3-month, and 6-month follow-up. Preoperative PedsQL subgroups were tested for an association with demographic and perioperative characteristics. Similarly, preoperative PedsQL subgroups were tested for an association with improvements in short- and intermediate-term PedsQL.

 RESULTS

A total of 53 patients were included in this analysis. Patients were grouped by their preoperative PedsQL scores: 30% had mild disability; 34% had moderate disability; and 36% had severe disability. There was a significant difference in age (p<0.001) among the subgroups; however, in terms of other demographic or operative factors there was no significant differences. The postoperative patient- and parent-reported PedsQL values were significantly different between all three groups at the 6-weeks, 3-months, and 6-months after surgery (p < 0.05), with few exceptions.  Patients with higher preoperative disability demonstrated statistically significant greater improvements (compared to preoperative score) in patient- and parent-reported PedsQL at all timepoints after surgery, with few exceptions.

 CONCLUSIONS

Patients with worse preoperative disability, as assessed by PedsQL, experienced lower absolute PedsQL scores at all timepoints after surgery, but had greater improvement in short- and intermediate-term PROs. We conclude that PedsQL is an efficient and accurate tool that can quickly assess patient disability in the preoperative period and predict both short-term and intermediate-term surgical outcomes.