Hemispherectomy Outcome Prediction Scale: a validity study

Author:

Hale Andrew T.1,Estevez-Ordonez Dagoberto1,Badrani Jana2,Sha Wen3,Arynchyna-Smith Anastasia4,Goyal Monisha5,Mohamed Ismail5,Kankirawatana Pongkiat5,Rozzelle Curtis J.14,Blount Jeffrey P.14

Affiliation:

1. Department of Neurosurgery, University of Alabama at Birmingham;

2. Heersink School of Medicine, University of Alabama at Birmingham;

3. Department of Public Health, Heersink School of Medicine, University of Alabama at Birmingham;

4. Division of Pediatric Neurosurgery, Children’s of Alabama, Birmingham; and

5. Division of Pediatric Neurology, Children’s of Alabama, Birmingham, Alabama

Abstract

OBJECTIVE Hemispherectomy is highly effective for patients with medically refractory epilepsy (MRE) arising from a single hemisphere. Recently, the Hemispherectomy Outcome Prediction Scale (HOPS) was developed as a prediction tool for seizure freedom after hemispherectomy. The authors’ goal was to perform a validation study to determine the generalizability of the HOPS score. METHODS The authors present an observational, retrospective, 20-year, single-institution, two-surgeon experience using the lateral peri-insular hemispherectomy approach to validate the HOPS score. Variables used to derive the HOPS score included seizure onset age, semiology, PET hypometabolism, seizure substrate, and history of prior epilepsy resection. Multivariable logistic regression, multiple imputation, and Bayesian analyses were used to determine validity. RESULTS The authors’ cohort comprised 60 patients; 55% of patients were male and 78% were Caucasian. The median age at first hemispherectomy surgery was 72 months. At 1 year postoperatively, 80% of patients had Engel class I outcomes, analogous to most contemporary series. All patients who experienced seizure recurrence after hemispherectomy did so within the first 2 years postoperatively. Sixteen (27%) and 10 (17%) patients had contralateral MRI findings and hypometabolism on PET, respectively. Both a multivariable logistic regression model using HOPS score variables (model p = 0.2588) and a revised model that included contralateral MRI findings (model p = 0.4715) were not statistically significant in this cohort. Bayesian analysis also did not validate the HOPS score. CONCLUSIONS While seizure outcome prediction tools may be helpful for counseling patients about postoperative outcomes, rigorous validity and reliability testing are required. Prospective, standardized, and longitudinal evaluation of patients undergoing hemispherectomy are needed.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

General Medicine

Reference35 articles.

1. Removal of right cerebral hemisphere for certain tumors with hemiplegia: preliminary report;Dandy WE,1928

2. Hemispherical deafferentation: an alternative to functional hemispherectomy;Schramm J,1995

3. Peri-insular hemispherotomy: surgical principles and anatomy;Villemure JG,1995

4. Hemispherectomy for intractable seizures in children: a report of 58 cases;Peacock WJ,1996

5. Hemispherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review;Griessenauer CJ,2015

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3