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Effectiveness of the Chiari Health Index for Pediatrics instrument in measuring postoperative health-related quality of life in pediatric patients with Chiari malformation type I.
- Source :
-
Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2020 Dec 04; Vol. 27 (2), pp. 139-144. Date of Electronic Publication: 2020 Dec 04 (Print Publication: 2021). - Publication Year :
- 2020
-
Abstract
- Objective: The authors' previously published work validated the Chiari Health Index for Pediatrics (CHIP), a new instrument for measuring health-related quality of life (HRQOL) for pediatric Chiari malformation type I (CM-I) patients. In this study, the authors further evaluated the CHIP to assess HRQOL changes over time and correlate changes in HRQOL to changes in symptomatology and radiological factors in CM-I patients who undergo surgical intervention. Strong HRQOL evaluation instruments are currently lacking for pediatric CM-I patients, creating the need for a standardized HRQOL instrument for this patient population. This study serves as the first analysis of the CHIP instrument's effectiveness in measuring short-term HRQOL changes in pediatric CM-I patients and can be a useful tool in future CM-I HRQOL studies.<br />Methods: The authors evaluated prospectively collected CHIP scores and clinical factors of surgical intervention in patients younger than 18 years. To be included, patients completed a baseline CHIP captured during the preoperative visit, and at least 1 follow-up CHIP administered postoperatively. CHIP has 2 domains (physical and psychosocial) comprising 4 components, the 3 physical components of pain frequency, pain severity, and nonpain symptoms, and a single psychosocial component. Each CHIP category is scored on a scale, with 0 indicating absent and 1 indicating present, with higher scores indicating better HRQOL. Wilcoxon paired tests, Spearman correlations, and linear regression models were used to evaluate and correlate HRQOL, symptomatology, and radiographic factors.<br />Results: Sixty-three patients made up the analysis cohort (92% Caucasian, 52% female, mean age 11.8 years, average follow-up time 15.4 months). Dural augmentation was performed in 92% of patients. Of the 63 patients, 48 reported preoperative symptoms and 42 had a preoperative syrinx. From baseline, overall CHIP scores significantly improved over time (from 0.71 to 0.78, p < 0.001). Significant improvement in CHIP scores was seen in patients presenting at baseline with neck/back pain (p = 0.015) and headaches (p < 0.001) and in patients with extremity numbness trending at p = 0.064. Patients with syringomyelia were found to have improvement in CHIP scores over time (0.75 to 0.82, p < 0.001), as well as significant improvement in all 4 components. Additionally, improved CHIP scores were found to be significantly associated with age in patients with cervical (p = 0.009) or thoracic (p = 0.011) syrinxes.<br />Conclusions: The study data show that the CHIP is an effective instrument for measuring HRQOL over time. Additionally, the CHIP was found to be significantly correlated to changes in symptomatology, a finding indicating that this instrument is a clinically valuable tool for the management of CM-I.
- Subjects :
- Adolescent
Child
Female
Follow-Up Studies
Health Status
Humans
Male
Pain Measurement
Postoperative Period
Predictive Value of Tests
Quality of Life
Retrospective Studies
Treatment Outcome
Young Adult
Arnold-Chiari Malformation psychology
Arnold-Chiari Malformation surgery
Neurosurgical Procedures methods
Neurosurgical Procedures psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0715
- Volume :
- 27
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery. Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 33276337
- Full Text :
- https://doi.org/10.3171/2020.7.PEDS20250