Jan H Koetje1,2, Vincent B Nieuwenhuijs1, Tanya Irvine2, George C Mayne2, David I Watson3. 1. Department of Surgery, Isala, Zwolle, Overijssel, The Netherlands. 2. Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, SA, 5042, Australia. 3. Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, SA, 5042, Australia. david.watson@flinders.edu.au.
Abstract
INTRODUCTION: Outcome following fundoplication for gastroesophageal reflux can be measured using objective tests, symptom scores and quality of life (QoL) measures. Which is best and how these assessments correlate is uncertain. To determine the utility of assessment measures we compared a general QoL measure (SF-36) and a disease-specific measure (GERD-hr-QoL) with symptom and satisfaction scores in individuals following fundoplication. METHODS: 329 individuals underwent fundoplication between 2000 and 2015 in 2 centres in Australia and the Netherlands. Patients were assessed before and 3, 12 and 24 months after surgery using 10-point Likert scales to assess heartburn and satisfaction, the SF-36 questionnaire and the GERD-hr-QoL questionnaire. SF-36 scores were converted into component scores: Physical Component Scale (PCS) score and Mental Component Scale (MCS) score. Correlations between QoL measures and clinical outcomes were determined. RESULTS: Surgery relieved heartburn (7.0 vs. 0.0 median, P < 0.001) and patients were highly satisfied with the outcome (median 9.0). PCS and MCS scores improved after surgery (PCS 40.9 vs. 46.0, P < 0.001; MCS 47.6 vs. 50.3, P = 0.027). GERD-hr-QoL scores also improved after surgery (15.7 vs. 3.7, P < 0.001). Correlations between PCS and MCS scores versus heartburn and satisfaction scores were generally weak or absent. However, correlations between GERD-hr-QoL versus heartburn and satisfaction scores were moderate to strong. CONCLUSION: Despite improvements in scores, the SF-36 correlated poorly with clinical outcome measures, and its use to measure outcome following fundoplication is questioned. However, the GERD-hr-QoL correlated well with the symptom scores, suggesting this disease-specific QoL measure is a better tool for assessing anti-reflux surgery outcome.
INTRODUCTION: Outcome following fundoplication for gastroesophageal reflux can be measured using objective tests, symptom scores and quality of life (QoL) measures. Which is best and how these assessments correlate is uncertain. To determine the utility of assessment measures we compared a general QoL measure (SF-36) and a disease-specific measure (GERD-hr-QoL) with symptom and satisfaction scores in individuals following fundoplication. METHODS: 329 individuals underwent fundoplication between 2000 and 2015 in 2 centres in Australia and the Netherlands. Patients were assessed before and 3, 12 and 24 months after surgery using 10-point Likert scales to assess heartburn and satisfaction, the SF-36 questionnaire and the GERD-hr-QoL questionnaire. SF-36 scores were converted into component scores: Physical Component Scale (PCS) score and Mental Component Scale (MCS) score. Correlations between QoL measures and clinical outcomes were determined. RESULTS: Surgery relieved heartburn (7.0 vs. 0.0 median, P < 0.001) and patients were highly satisfied with the outcome (median 9.0). PCS and MCS scores improved after surgery (PCS 40.9 vs. 46.0, P < 0.001; MCS 47.6 vs. 50.3, P = 0.027). GERD-hr-QoL scores also improved after surgery (15.7 vs. 3.7, P < 0.001). Correlations between PCS and MCS scores versus heartburn and satisfaction scores were generally weak or absent. However, correlations between GERD-hr-QoL versus heartburn and satisfaction scores were moderate to strong. CONCLUSION: Despite improvements in scores, the SF-36 correlated poorly with clinical outcome measures, and its use to measure outcome following fundoplication is questioned. However, the GERD-hr-QoL correlated well with the symptom scores, suggesting this disease-specific QoL measure is a better tool for assessing anti-reflux surgery outcome.
Authors: Michael Camilleri; Dominique Dubois; Bernard Coulie; Michael Jones; Peter J Kahrilas; Anne M Rentz; Amnon Sonnenberg; Vincenzo Stanghellini; Walter F Stewart; Jan Tack; Nicholas J Talley; William Whitehead; Dennis A Revicki Journal: Clin Gastroenterol Hepatol Date: 2005-06 Impact factor: 11.382
Authors: D Korolija; S Sauerland; S Wood-Dauphinée; C C Abbou; E Eypasch; M García Caballero; M A Lumsden; B Millat; J R T Monson; G Nilsson; R Pointner; W Schwenk; A Shamiyeh; A Szold; E Targarona; B Ure; E Neugebauer Journal: Surg Endosc Date: 2004-04-27 Impact factor: 4.584
Authors: C Engström; W Cai; T Irvine; P G Devitt; S K Thompson; P A Game; J R Bessell; G G Jamieson; D I Watson Journal: Br J Surg Date: 2012-10 Impact factor: 6.939
Authors: Gianluca Rossetti; Paolo Limongelli; Marco Cimmino; Domenico Napoletano; Maria Chiara Bondanese; Giovanni Romano; Manousos Pratilas; Ludovica Guerriero; Francesco Orlando; Giovanni Conzo; Bruno Amato; Giovanni Docimo; Salvatore Tolone; Luigi Brusciano; Ludovico Docimo; Landino Fei Journal: Int J Surg Date: 2014-06-02 Impact factor: 6.071
Authors: Jan H Koetje; Jelmer E Oor; David J Roks; Henderik L Van Westreenen; Eric J Hazebroek; Vincent B Nieuwenhuijs Journal: Surg Endosc Date: 2017-01-11 Impact factor: 4.584
Authors: Jun Liang Teh; Hui Yu Tham; Alex Yu Sen Soh; Corrisa Chee; Guowei Kim; Asim Shabbir; Reuben Kong Min Wong; Jimmy Bok Yan So Journal: Surg Endosc Date: 2021-07-29 Impact factor: 4.584