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Predicting epilepsy surgery outcome in adult patients: May psychiatric diagnosis improve predictive models?
Filipa Novais1, Luís Câmara Pestana1, Susana Loureiro1
1Department of Neurosciences and Mental Health, Psychiatry Department, Hospital de Santa Maria (CHULN), Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Portugal; Centro de Referência de Epilepsia Refratária, Hospital de Santa Maria, (CHULN), Lisboa, Portugal; EpiCARE Network, European Reference Network for rare and complex epilepsies, Portugal.
Objective:
With this study, we aimed to assess the importance of including psychiatric disorders in a comprehensive prediction model for epilepsy surgery.
Methods:
Ambispective observational study with a sample of adults who underwent resective surgery. Participants were evaluated, before and one year after surgery, to collect data regarding their neurological and psychiatric history. The one-year post-surgical outcome was classified according to the Engel Outcome Scale. Previously identified predictors of post-surgical Engel Class were included in a logistic regression model. Then, the accuracy of alternative predictive models, including or excluding, past and current psychiatric diagnoses, were tried.
Results:
One hundred and forty-six people participated in this study. The inclusion of psychiatric diagnosis resulted in a model with a higher AUC curve, however, the Delong method showed no significant statistical differences between the models.
Significance:
Despite the fact that presurgical psychiatric diagnoses have shown to contribute to the prediction of epilepsy surgery outcome they do not contribute to a significant improvement of predictive models.
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