Psychological resilience is related to postoperative adverse events and quality of life in patients with glioma: a retrospective cohort study

Abstract

Background: Psychological resilience has played an increasingly important role in the treatment of different diseases and many glioma patients will experience adverse emotional reactions after being diagnosed. However, it remains unclear whether psychological resilience is related to the adverse events and quality of life of patients with glioma. Methods: Patients with glioma between March 2016 and July 2020 were included in this retrospective cohort study. Psychological resilience was evaluated by the Connor-Davidson resilience scale (CD-RISC) 1 day before surgery. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and EORTC QLQ-BN20 were used for the quality of life (QoL) assessment of the included patients. The relationships between psychological resilience and postoperative adverse events/QoL were determined using multivariable logistic and linear regression analysis, respectively. Some patients were evaluated again after admission, and the patients were divided into an increased resilience group and decreased resilience group for subgroup analysis according to the changes between the two CD-RISC scores. All included patients were followed up for at least 6 months. Results: Ninety-seven patients were included in the high resilience group and 284 patients were included in the low resilience group. More neurological complications occurred in the low resilience group than in the high resilience group (18.7% vs. 8.2%, P=0.016). Also, a higher Karnofsky performance scale score and higher psychological resilience contributed to less adverse events. Patients in the high resilience group had higher postoperative global health status scores than those in the low resilience group. Higher educational level, Karnofsky performance scale score, and psychological resilience acted as a protective factor for postoperative QoL. Subgroup analysis showed that the incidence of neurological complications was significantly higher in the decreased resilience group compared to the increased resilience group (22.9% vs. 3.8%, P=0.039). Lastly, better global health status, physical functioning, and role functioning were observed in glioma patients with increased resilience. Conclusions: The incidence of postoperative adverse events and QoL of glioma patients are closely related to their level of preoperative psychological resilience. Psychological counseling may also be a part of improving the prognosis of glioma patients.