EP15.03 PAEDIATRIC FOURTH VENTRICULAR TUMORS -CLINICO-PATHOLOGICAL STUDY WITH ASSESSMENT OF QUALITY OF LIFE OF CAREGIVERS: PERSPECTIVE FROM INDIA

Abstract BACKGROUND Fourth ventricular tumors are one of the common tumors visiting Neurosurgery OPD in India. Multimodality approach involves a dedicated and often a long-term patient care and rehabilitation. Diagnosis and management of the brain tumors requires multiple hospital visits and brings about unique challenges to the caregiver. Quality of life of the caregiver is invariably affected in these circumstances. A drastic change in the quality of life of the caregiver may lead to poor compliance to the treatment and inferior outcome. Most of the literature available on quality-of-life assessment is from developed countries and cannot be extrapolated in Indian scenario. Studying the clinical profile of paediatric fourth ventricle tumors and its effect on the quality of life of the caregiver provided us a valuable data which can be further utilized to make positive changes in the institutional policies in India. MATERIAL AND METHODS This prospective study was conducted at Neurosurgery department King George’s Medical University, India over a period 6 months from January 2024 to June 2024. Detailed clinical & radiological profile and histopathology was documented. Surgical procedures, intraoperative events, duration of hospital stay, mortality, morbidity and follow up details were also noted. Details of caregiver were noted and Quality of life of caregiver was evaluated based on World Health Organization Quality of Life- BREF (WHOQOL- BREF) questionnaire at time of admission and at 3 month follow up. The domains in above questionnaire were physical health, psychological, social relationships and environment. Change in above scores was assessed in four categories-children with clinical deterioration trend, improving trend, constant trend and expired after discharge. RESULTS 30 patients were part of the study with age ranging from 6 months to 12 years. Medulloblastoma was the most common pathological entity. In hospital mortality of 13.3% was recorded. All those children who had deteriorated in their morbidity status (5), their caregivers showed decline in their WHO- TOTAL QOL index and WHO-Environment domain. There was a statistically significant decline in the total score of QOL of caregiver of children with deteriorated trend and those who expired after discharge. The improvement in the total score of QOL of caregivers of children who had an improved clinical trend was not statistically significant. CONCLUSION The changes that occur in the quality of life of the caregiver during the treatment journey of these paediatric tumour’s patients were profound especially in the resource crunch settings in India. On understanding the observation of the study, it can be widely suggested that a neurosurgeon role in India expands beyond surgical intervention and it must encompass a constant introspection of outcomes and holistic approach towards patient caregiver unit.