Abstract：
OBJECTIVE: To examine patient characteristics that impact serial observation adherence among vestibular schwannoma (VS) patients.
METHODS: Retrospective chart review.
METHODS: Single tertiary care center.
METHODS: We selected for VS patients from 201 to 2020 who elected for serial observation as initial management. Patients under 18, with previous management, bilateral or intralabyrinthine VS, and neurofibromatosis type 2 were excluded. Demographics, tumor characteristics, and follow-up status were extracted. Single and multiple logistic regression was used to identify patient characteristics impacting follow-up.
RESULTS: We identified 507 VS patients who chose serial observation as initial management. Most were female (56.0%), white (73.0%), and married (72.8%). The mean age was 59.3 and most had private insurance (56.4%). Median Charlson Comorbidity Index was 2.00. Mean pure tone audiometry (PTA) average was 41.7 Hz. Average tumor size was 9.04 mm. Of 507 patients, 358 (70.6%) returned for at least one follow-up. On multiple logistic regression analysis, patients with private insurance (odds ratio [OR]: 0.39, confidence interval [CI]: 0.22-0.68; P = .001), racial minority background (OR: 0.54, CI: 0.35-0.83; P = .005), worse PTA averages (OR: 0.99, CI: 0.98-1.00; P = .044), and older age at diagnosis (OR: 0.97, CI: 0.95-1.00; P = .038) were less likely to follow-up.
CONCLUSIONS: Private health insurance, racial minority background, worse PTA average, and older age were associated with decreased follow-up among adult VS patients electing serial observation. Patients with these characteristics may require additional support to ensure serial observation adherence.
METHODS: Retrospective chart review.
METHODS: Single tertiary care center.
METHODS: We selected for VS patients from 201 to 2020 who elected for serial observation as initial management. Patients under 18, with previous management, bilateral or intralabyrinthine VS, and neurofibromatosis type 2 were excluded. Demographics, tumor characteristics, and follow-up status were extracted. Single and multiple logistic regression was used to identify patient characteristics impacting follow-up.
RESULTS: We identified 507 VS patients who chose serial observation as initial management. Most were female (56.0%), white (73.0%), and married (72.8%). The mean age was 59.3 and most had private insurance (56.4%). Median Charlson Comorbidity Index was 2.00. Mean pure tone audiometry (PTA) average was 41.7 Hz. Average tumor size was 9.04 mm. Of 507 patients, 358 (70.6%) returned for at least one follow-up. On multiple logistic regression analysis, patients with private insurance (odds ratio [OR]: 0.39, confidence interval [CI]: 0.22-0.68; P = .001), racial minority background (OR: 0.54, CI: 0.35-0.83; P = .005), worse PTA averages (OR: 0.99, CI: 0.98-1.00; P = .044), and older age at diagnosis (OR: 0.97, CI: 0.95-1.00; P = .038) were less likely to follow-up.
CONCLUSIONS: Private health insurance, racial minority background, worse PTA average, and older age were associated with decreased follow-up among adult VS patients electing serial observation. Patients with these characteristics may require additional support to ensure serial observation adherence.
摘要：
目的：研究影响前庭神经鞘瘤（VS）患者系列观察依从性的患者特征。
方法：回顾性图表回顾。
方法：单一三级护理中心。
方法：我们选择了201至2020年的VS患者，这些患者选择进行系列观察作为初始治疗。18岁以下的病人，以前的管理，双侧或行内，排除了2型神经纤维瘤病。人口统计,肿瘤特征，并提取随访情况。采用单因素和多因素logistic回归分析确定影响随访的患者特征。
结果：我们确定了507例VS患者选择了系列观察作为初始治疗。大多数是女性（56.0％），白色（73.0%），已婚（72.8%）。平均年龄为59.3，大多数人拥有私人保险（56.4％）。Charlson合并症指数中位数为2.00。平均纯音测听（PTA）平均值为41.7Hz。平均肿瘤大小为9.04mm。507名患者中,358（70.6%）返回至少一次随访。在多元logistic回归分析中，私人保险患者（比值比[OR]：0.39，置信区间[CI]：0.22-0.68；P=.001），种族少数背景（OR：0.54，CI：0.35-0.83；P=0.005），较差的PTA平均值（OR：0.99，CI：0.98-1.00；P=0.044），诊断时年龄较大(OR:0.97,CI:0.95-1.00;P=0.038)的随访可能性较小。
结论：私人医疗保险，种族少数背景，更差的PTA平均值，在选择连续观察的成年VS患者中，年龄和年龄与随访时间减少相关。具有这些特征的患者可能需要额外的支持以确保连续观察的依从性。
方法：回顾性图表回顾。
方法：单一三级护理中心。
方法：我们选择了201至2020年的VS患者，这些患者选择进行系列观察作为初始治疗。18岁以下的病人，以前的管理，双侧或行内，排除了2型神经纤维瘤病。人口统计,肿瘤特征，并提取随访情况。采用单因素和多因素logistic回归分析确定影响随访的患者特征。
结果：我们确定了507例VS患者选择了系列观察作为初始治疗。大多数是女性（56.0％），白色（73.0%），已婚（72.8%）。平均年龄为59.3，大多数人拥有私人保险（56.4％）。Charlson合并症指数中位数为2.00。平均纯音测听（PTA）平均值为41.7Hz。平均肿瘤大小为9.04mm。507名患者中,358（70.6%）返回至少一次随访。在多元logistic回归分析中，私人保险患者（比值比[OR]：0.39，置信区间[CI]：0.22-0.68；P=.001），种族少数背景（OR：0.54，CI：0.35-0.83；P=0.005），较差的PTA平均值（OR：0.99，CI：0.98-1.00；P=0.044），诊断时年龄较大(OR:0.97,CI:0.95-1.00;P=0.038)的随访可能性较小。
结论：私人医疗保险，种族少数背景，更差的PTA平均值，在选择连续观察的成年VS患者中，年龄和年龄与随访时间减少相关。具有这些特征的患者可能需要额外的支持以确保连续观察的依从性。
