Significance of critical life events for quality of life in people with epilepsy after presurgical assessment

Objectives: Critical life events (CLE) are known to influence patient-related outcomes such as health-related quality of life (HRQoL).Nevertheless, when studying effects of epilepsy surgery on HRQoL, CLE have not been systematically investigated yet.Thus, we studied relationships between CLE and HRQoL in epilepsy surgery candidates and possible differences between those undergoing surgery (surgery group) vs. those that did not complete surgery (no surgery group).Methods: Our prospective, bicentric study included 238 adult candidates for epilepsy surgery between 2018 and 2020.Participants filled out self-report questionnaires on psychosocial aspects including HRQoL and positive and negative CLE. T1 was at presurgical evaluation, T2 took place one year after T1 (surgery group) or one year after surgery (no surgery group).We tested (differential) effects of CLE occurring between T1 and T2 on HRQoL in multigroup regression analyses controlling for various potential confounders.Results: In both groups, negative CLE were linked to lower T2 HRQoL (surgery: = -1.4;no surgery: = -0.82,both p < 0.001).Positive CLE were associated with higher T2 HRQoL (surgery: = 0.81, p = 0.002; no surgery: = 0.70, p = 0.015).There was a trend towards a stronger negative link between negative CLE and HRQoL for the surgery group (difference = 0.576; Z = 1.55, p = 0.06).After controlling for confounders and CLE, T2 HRQoL was higher for the surgery compared to the no surgery group (M surgery = 50.64,M no surgery = 37.50, Z = 3.702, p < 0.001).Significance: CLE are relevant for HRQoL beyond treatment effects of epilepsy surgery.Furthermore, epilepsy surgery mayat least temporarilylead to greater vulnerability of negative effects of stressful CLE.This highlights the importance of a bio-psycho-social perspective on health in epilepsy.