Negligible QOL Impact from Serial Casting for EOSQNegligible QOL Impact from Serial Casting for EOSQ

Charles Johnston MD, Dong-Phuong Tran MS, Anna McClung RN BSN

BackgroundBackground• EOS 24-Item Questionnaire (EOSQ) is a parent-reported measurement used

to determine the overall well-being of EOS patients. • Serial casting is a delay tactic to control curve progression or cure scoliotic

deformity in EOS patients

Objective Objective

• To determine the relationship between treatment outcomes and patient report outcomes in patients treated with serial casting for EOS

MethodsMethods

• Prospective EOS patients treated with serial casting at a single institution

• EOSQ collection time points:• Initiation of casting• After removal of last cast in the series

• Categories:• Health-related quality of life • Family impact• Satisfaction

• Pearson’s correlation used to correlate total scores and each category and radiographic outcome

ResultsResults

• 24 patients have completed EOSQs• Diagnoses:• Neuromuscular- 2• Congenital – 2• Syndromic – 5• Idiopathic – 15

• Number of casts: 4.2; 2 – 9• Time spent in cast: 9.8 months; 1.8 – 34.2 months• Overall major curve decreased by 27% and thoracic

height increased by 1.6 cm

Results (cont.)Results (cont.)

Precast (Mean; range)

Postcast(Mean; range)

p value

Age 3 years; 1 – 9 4.7 years; 3 – 5

Standing height 96.5 cm; 69 – 156.4 102.1 cm; 82 – 140 0.008

Weight 14 kg; 7.5 22.5 17.1 kg; 10.7 – 25.1 0.329

Arm span 94.9 cm; 69 – 142 104.6 cm; 80 – 148 cm <0.000

Major Cobb 55°; 28 – 126 44.2°; 10 – 131 0.001

Thoracic height (T2 – T12)

146.4 cm; 103 – 206 160.9 cm; 123 – 210 <0.000

ResultsResults

• No significant differences between clinical and radiographic measures and pre-cast EOSQ scores

• Positive correlation between post-cast major curve and post-cast total score (r=0.41, p=.049)

• Greater time in cast produced decreased Pain/Discomfort score (r=-0.43, p=0.0036)

• Larger post-cast Cobb was associated with a lower Emotion score (r=-0.45, p=0.03)

EOSQ ScoresEOSQ Scores

Pre-Cast EOSQ Mean

Post-Cast EOSQ Mean P value

General Health (GH) 75.0 77.1 0.66Pain/Discomfort (PD) 79.2 77.1 0.65Pulmonary Function (PF) 91.1 88.5 0.58Transfer (TF) 89.6 72.9 0.01Physical Function (PH) 83.0 79.5 0.51Daily Living (DL) 74.0 66.7 0.17Fatigue/Energy Level (FE) 79.2 75.5 0.44Parental Impact (PI) 86.5 80.7 0.17Financial Impact (FI) 75.0 77.9 0.39Child Satisfaction (CS) 77.1 72.9 0.40Parental Satisfaction (PS) 79.2 75.5 0.47Total 100.8 98.1 0.31

• Precast EOSQ total score mean was 100.8 – families were unaffected to by their child’s EOS, individual domains ranged from unaffected to neutral

• In all EOSQ domains, the only significant difference between pre and post-cast was Transfer (TF)

Conclusions Conclusions

• EOS families experience a negligible impact from their child’s cast treatment as measured by the EOSQ.

• A larger residual major curve leads to a lower total score and emotional domain, while a longer time in cast negatively impacts family’s perception of patient pain.

Thank YouThank You