E Bosma1, M J J Pullens2, J de Vries2,3, J A Roukema2,3,4. 1. Department of Surgery, Martini Hospital, Groningen, The Netherlands. 2. Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Disease (CoRPS), Tilburg University, Tilburg, The Netherlands. 3. Department of Medical Psychology, St Elisabeth Hospital, Tilburg, The Netherlands. 4. Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
Abstract
AIM: This prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien-Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures. METHOD: Patients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression. RESULTS: Of 218 patients, 130 (59.6%) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho -0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks. CONCLUSION: Severe complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC. Colorectal Disease
AIM: This prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien-Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures. METHOD:Patients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression. RESULTS: Of 218 patients, 130 (59.6%) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho -0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks. CONCLUSION: Severe complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC. Colorectal Disease
Authors: Lauren Dautzenberg; Judith E M Pals; Geert J Lefeber; Pieter R Stella; Masieh Abawi; Marielle Emmelot-Vonk; Huiberdina L Koek Journal: Open Heart Date: 2021-09
Authors: Christoph A Fink; Mirco Friedrich; Pia-Elena Frey; Lukas Rädeker; Alexander Leuck; Thomas Bruckner; Manuel Feisst; Solveig Tenckhoff; Christina Klose; Colette Dörr-Harim; Jens Neudecker; André L Mihaljevic Journal: BMC Surg Date: 2018-10-29 Impact factor: 2.102