Aurélie Comptour1, Bruno Pereira2, Céline Lambert2, Pauline Chauvet1, Anne-Sophie Grémeau1, Jean-Luc Pouly1, Michel Canis1, Nicolas Bourdel3. 1. CHU Clermont-Ferrand, Service de Chirurgie Gynécologique (Drs. Comptour, Chauvet, Grémeau, Pouly, Canis, and Bourdel). 2. Unités de Biostatistiques Direction de la Recherche Clinique et de l'Innovation (DRCI) (Drs. Pereira and Lambert), Clermont-Ferrand, France. 3. CHU Clermont-Ferrand, Service de Chirurgie Gynécologique (Drs. Comptour, Chauvet, Grémeau, Pouly, Canis, and Bourdel). Electronic address: nbourdel@chu-clermontferrand.fr.
Abstract
STUDY OBJECTIVE: To investigate predictive factors for change in quality of life (QOL) between pre- and postoperative periods in patients with endometriosis. DESIGN: A prospective and multicenter cohort study. SETTING: Five districts including a tertiary referral center and private and general public hospitals. PATIENTS: Nine hundred eighty-one patients aged 15 to 50 years underwent laparoscopic treatment (preferred approach) for endometriosis between January 2004 and December 2012. INTERVENTIONS: Laparoscopic treatment for endometriosis. All revised American Fertility Society stages were included. MEASUREMENTS AND MAIN RESULTS: QOL was evaluated using the 36-Item Short Form Survey questionnaire. Factors influencing changes for each 36-Item Shorty Form Survey domain score between t0 (before surgery) and 1 year after surgery were predicted on the basis of univariate and multivariable analyses. The effect size (ES) method was used to measure changes in QOL. Univariate analysis revealed that 47% of stage IV endometriosis patients presented an improvement in the postoperative Physical Component Summary (PCS) score (ES ≥ 0.8) versus 26%, 31.3%, and 27.5% of patients with stage I, II, and III, respectively (p <.001). Forty-four percent and 38% of patients with chronic pelvic pain (CPP) presented an improvement in postoperative PCS and Mental Component Summary scores (ES>0.8) versus 23% and 24% of patients without CPP, respectively (p <.001). Multivariable analysis (ES > 0.8 vs ES < 0) revealed that women with CPP were more likely to experience greater improvement in postoperative PCS and Mental Component Summary scores than women without CPP (relative risk [RR] = 2.7; 95% confidence interval [CI], 1.7-4.4; p <.001 and RR = 1.8; 95% CI, 1.2-2.8; p <.01, respectively). Accordingly, fertile patients were more likely to show higher rates of improvement in the postoperative PCS score than infertile patients (RR = 1.8; 95% CI, 1.1-3.1; p <.05). CONCLUSION: Patients presenting with severe endometriosis and who experience higher levels of pain are more likely to show improvement in QOL after surgery. CPP is the most significant independent predictive factor for changes in QOL scores.
STUDY OBJECTIVE: To investigate predictive factors for change in quality of life (QOL) between pre- and postoperative periods in patients with endometriosis. DESIGN: A prospective and multicenter cohort study. SETTING: Five districts including a tertiary referral center and private and general public hospitals. PATIENTS: Nine hundred eighty-one patients aged 15 to 50 years underwent laparoscopic treatment (preferred approach) for endometriosis between January 2004 and December 2012. INTERVENTIONS: Laparoscopic treatment for endometriosis. All revised American Fertility Society stages were included. MEASUREMENTS AND MAIN RESULTS: QOL was evaluated using the 36-Item Short Form Survey questionnaire. Factors influencing changes for each 36-Item Shorty Form Survey domain score between t0 (before surgery) and 1 year after surgery were predicted on the basis of univariate and multivariable analyses. The effect size (ES) method was used to measure changes in QOL. Univariate analysis revealed that 47% of stage IV endometriosispatients presented an improvement in the postoperative Physical Component Summary (PCS) score (ES ≥ 0.8) versus 26%, 31.3%, and 27.5% of patients with stage I, II, and III, respectively (p <.001). Forty-four percent and 38% of patients with chronic pelvic pain (CPP) presented an improvement in postoperative PCS and Mental Component Summary scores (ES>0.8) versus 23% and 24% of patients without CPP, respectively (p <.001). Multivariable analysis (ES > 0.8 vs ES < 0) revealed that women with CPP were more likely to experience greater improvement in postoperative PCS and Mental Component Summary scores than women without CPP (relative risk [RR] = 2.7; 95% confidence interval [CI], 1.7-4.4; p <.001 and RR = 1.8; 95% CI, 1.2-2.8; p <.01, respectively). Accordingly, fertile patients were more likely to show higher rates of improvement in the postoperative PCS score than infertilepatients (RR = 1.8; 95% CI, 1.1-3.1; p <.05). CONCLUSION:Patients presenting with severe endometriosis and who experience higher levels of pain are more likely to show improvement in QOL after surgery. CPP is the most significant independent predictive factor for changes in QOL scores.
Authors: A M F Schreurs; E A F Dancet; S Apers; M van Hoefen Wijsard; W K H Kuchenbecker; P M van de Ven; C B Lambalk; W L D M Nelen; L E E van der Houwen; V Mijatovic Journal: Hum Reprod Open Date: 2020-09-22
Authors: Monika Ruszała; Dominik Franciszek Dłuski; Izabela Winkler; Jan Kotarski; Tomasz Rechberger; Marek Gogacz Journal: J Clin Med Date: 2022-04-06 Impact factor: 4.241
Authors: Charles Chapron; Marie-Christine Lafay-Pillet; Pietro Santulli; Mathilde Bourdon; Chloé Maignien; Antoine Gaudet-Chardonnet; Lorraine Maitrot-Mantelet; Bruno Borghese; Louis Marcellin Journal: EClinicalMedicine Date: 2022-01-10