Iranian specialists’ approach to surgery in patients with multiple sclerosis

Fereshteh Ghadiri; Zahra Ebadi; Elnaz Asadollahzadeh; Mohammad AliSahraian; Amirreza Azimi; Samira Navardi; Hora Heidari; Zohreh Abna; Marzieh Aboutorabi; Iman Adibi; Seyed Mohammad Baghbanian; Sepideh Paybast; Maryam Poursadeghfard; Samaneh Hosseini; Sareh Shahmohammadi; Mehran Ghaffari; Hamidreza  Ghalyanchi-Langroodi; Masoud Ghiasian; Hoda Kamali; Ebrahim Kouchaki; Farzad Mahrabi; Ehsan Mohammadianinejad; Mohammad Ali Nahayati; Abdorreza Naser Moghadasi

doi:10.18502/cjn.v22i2.13336

Fereshteh Ghadiri Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Zahra Ebadi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Elnaz Asadollahzadeh Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad AliSahraian Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Amirreza Azimi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Samira Navardi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Hora Heidari Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Zohreh Abna Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Marzieh Aboutorabi Department of Neurology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Iman Adibi Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Seyed Mohammad Baghbanian Department of Neurology, Booalicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
Sepideh Paybast Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Maryam Poursadeghfard Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Samaneh Hosseini Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Sareh Shahmohammadi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mehran Ghaffari Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hamidreza Ghalyanchi-Langroodi Clinical Development and Research Unit, Ghaem Hospital, Gilan University of Medical Sciences, Rasht, Iran
Masoud Ghiasian Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
Hoda Kamali Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
Ebrahim Kouchaki Department of Neurology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
Farzad Mahrabi Department of Neurology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
Ehsan Mohammadianinejad Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Ali Nahayati Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Abdorreza Naser Moghadasi Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cjn.v22i2.13336

Keywords: Infections; Multiple Sclerosis; Postoperative Complications; Surgery

Abstract

Background: Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).

Methods: 21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation. The reasons for refusing surgery or factors that have to be considered before surgery were studied.

Results: Overall, Fleiss Kappa was estimated to be 0.091 [95% confidence interval (CI): 0.090-0.093,
P < 0.001] indicating a very poor level of agreement among responders.

Conclusion: PwMS face surgery for various reasons. Risk assessment of surgery, the effect of various drugs such as anesthetics and DMT on patients, as well as many other aspects of MS are issues challenging the practitioners. Clarifying the various dimensions of these issues requires further research.