The impact of visual impairment on Health-Related Quality of Life (HRQoL) scores in brain tumour patients

Abstract

Brain tumour patients have significant disability and symptom burden. Health-Related Quality of Life (HR-QoL) scores can be useful when assessing the impact brain tumours have on their QoL.1. To determine whether there are any statistically significant differences in HRQoL scores in brain tumour patients with visual impairment compared to those without. 2. To compare pre- and post-operative HR-QoL scores in patients whose vision was not impaired pre-operatively but that deteriorated post-operatively, and assess whether there were any statistically significant differences in each of the QoL dimensions. 3. To see if there was an association between visual impairment and a) tumour type and b) tumour location.Suitable patients confirmed to have brain tumours were recruited at neuro-oncology clinics from 2010–2013. We analysed HR-QoL scores from a total of 175 patients, either pre- or post-operatively (or for a minority of patients, both).1. The mean HRQoL scores for all of the QoL domains were higher (equating to higher functionality) in patients without visual impairment compared to those with and this was statistically significant (p=<0.05) for a) Global Health b) Role c) Emotional and d) Cognitive functioning. 2. Comparisons of HRQoL scores pre- and post-operatively in 11 patients who had no visual impairment pre-operatively but whose vision deteriorated post-operatively reveals statistically significant (p=<0.05) decreases in global health and cognitive functioning post-operatively. 3. There was no association between visual impairment and type of tumour but a strong association between visual impairment and occipital tumours.1. Visual impairment has a huge impact on brain tumour patients’ QoL. 2. HRQoL scores may be very useful as primary outcome measures in the future. 3. Surgical intervention in brain tumour patients often results in huge deteriorations in their QoL and hence may not always be in the patients’ best interest.