title: Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery.
abstract: BACKGROUND
  Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist.
  
  
  OBJECTIVE
  To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery.
  
  
  METHODS
  We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland.
  
  
  RESULTS
  Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience.
  
  
  CONCLUSIONS
  Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.
authors.affiliation: *Department of Anesthesiology and Intensive Care Medicine, ‡Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Reponen
authors.forename: Hanna
authors.initials: H
authors.lastname: Tuominen
authors.forename: Juha
authors.initials: J
authors.lastname: Hernesniemi
authors.forename: Miikka
authors.initials: M
authors.lastname: Korja
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003399:Craniotomy / Q000401:mortality / Q000523:psychology* / Q000639:trends; D017558:Elective Surgical Procedures / Q000401:mortality / Q000523:psychology* / Q000639:trends; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000401:mortality / Q000523:psychology* / Q000639:trends; D017060:Patient Satisfaction; D011184:Postoperative Period; D011446:Prospective Studies; D012886:Skull / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult