Patients with Crohn's disease may undergo multiple surgical procedures.
The effect of this surgery on quality of life (QOL) in the early postoperative period is important as acute benefits may occur due to modifications in medical treatment.
Previous studies assessing the effect of surgery on QOL have been retrospective, and have evaluated the period 3 to 24 months after surgery.
In this study, researchers from Cleveland, Ohio, prospectively assessed the effect of surgery on QOL in the early postoperative period.
The team selected patients who required surgical management of sequelae of Crohn's disease from a prospectively entered database. The database included information on QOL.
The researchers determined preoperative and 30-day postoperative QOL for 82 patients using Cleveland Global Quality of Life (CGQL) scores. Scores could range from 0 (worst) to 10 (best).
Pre- and postoperative scores were compared to evaluate any possible change in QOL after surgery.
|Female patients, and those without complications, had the greatest improvement in QOL after surgery.|
|Journal of the American College of Surgeons|
Any other variables influencing QOL after surgery were also evaluated.
The team used multifactor analysis of variance to assess the effect of several independent variables.
The research team found that the incidence of complications was 23%, and 11% of these were major.
They identified a significant improvement in QOL 30 days after surgery. Overall, the mean preoperative CGQL score was 0.56, and the mean improvement was 0.11 points toward a better QOL.
The team determined that female patients, and those who did not develop complications within 30 days of surgery, had the greatest improvement in QOL after surgery.
They identified no other factors that were predictive of improved outcomes.
Dr Conor Delaney's team concluded, "QOL as measured by CGQL improves early after surgery (30 days postoperatively)".
"Improvement in CGQL is greater in female patients and patients who do not develop complications in the postoperative period".
"It is not affected by other patient characteristics, nature of disease, indication, or procedure performed".
"Most patients who undergo surgery for Crohn's disease feel that surgery has helped them and would undergo surgery again".