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RACS ASC 2024

Do Less Harm: next of kin responses to a questionnaire on the treatment of GBM in the elderly.

Poster

Presentation Description

Institution: Te Whatu Ora - Wellington, Aotearoa New Zealand

Purpose: Glioblastoma (GB) is associated with a poor prognosis. Post-operative median survival is estimated to be 1.8 months1 in elderly comorbid patients. This study evaluates next of kin (NOK) experiences whose elderly loved-ones received surgical treatment for their GB. Methodology: All NOK of patients 60 years and older who underwent surgical intervention for a histologically confirmed GB at a single centre between February 2010 and November 2018 were sent a questionnaire. Of 206 eligible participants, 124 NOK responded. Eighteen questions on a Likert scale addressed a range of pre and post op processes. Responses were analysed thematically and for statistical association using R statistical programme with days of functional independence (DFI) and days to death (DTD). A reproducibility study was performed with a 64% response rate. Results: NOK positively responded that they received enough information to consent, surgical outcomes were as expected, they would choose surgery again, and they would recommend surgery to other friends/family. There was a negative response on whether symptoms improved post-op and post-all treatments. Plotting Kendall’s correlation coefficients, DFI was an observably better predictor of NOK satisfaction than DTD; however, the difference was not statistically significant. The reproducibility study demonstrated an 85.4% repeatability of NOK responses. Conclusion: Overall, NOK were satisfied with the treatment patients received. These responses were most closely associated with DFI. As clinicians, we should set more accurate expectations of post-op morbidity during the informed consent process to enable patients and NOK to make better decisions. Reference: 1. Scott et al. Neuro-Oncology. 2011.

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Authors

Authors

Dr Mairarangi Haimona - , Dr Robin Willink - , Mr Agadha Wickremesekera - , Dr Rosanna Rahman (Pi) -