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QoL was measured using the anterior skull base surgery questionnaire (ASBS). Factors associated with QoL at baseline and at 12-month follow-up were identified using multivariate logistic regression. Multiple supervised learning models were trained to predict postoperative QoL improvement with five-fold cross-validation.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Results<\/jats:title><jats:p>ASBS at 12-month follow-up was significantly higher (132.19,SD = 24.87) than preoperative ASBS (121.87,SD = 25.72,p&lt;0.05). High preoperative scores were significantly associated with institution, diabetes and lesions at the planum sphenoidale \/ tuberculum sella site. Patients with diabetes were five times less likely to report high preoperative QoL. Low preoperative QoL was significantly associated with female gender, a vision-related presentation, diabetes, secreting adenoma and the cavernous sinus site. Top quartile change in postoperative QoL at 12-month follow-up was negatively associated with baseline hypercholesterolemia, acromegaly and intraoperative CSF leak. Positive associations were detected for lesions at the sphenoid sinus site and deficient preoperative endocrine function. AdaBoost, logistic regression and neural network classifiers yielded the strongest predictive performance.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusion<\/jats:title><jats:p>It was possible to predict postoperative positive change in QoL at 12-month follow-up using perioperative data. Further development and implementation of these models may facilitate improvements in informed consent, treatment decision-making and patient QoL.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0272147","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T17:49:11Z","timestamp":1658944151000},"page":"e0272147","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predictors of improvement in quality of life at 12-month follow-up in patients undergoing anterior endoscopic skull base surgery"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-3223","authenticated-orcid":true,"given":"Quinlan 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