Influence of age and gender on quality-of-life outcomes after cholecystectomy

Abstract

Few studies have assessed the role of sociodemographic characteristics on outcomes after a cholecystectomy. Our goal was to evaluate the influence of age and gender on the health related quality of life (HRQoL) changes after cholecystectomy in this prospective observational study of consecutive patients undergoing cholecystectomy. Patients completed the SF-36 and the Gastrointestinal Quality of Life Index (GIQLI) before intervention and 3 months later. The influence of age, gender, and the pre-intervention health status on the HRQoL changes was studied by multivariate regression analysis. Older patients had poorer HRQoL and their post-intervention improvement was lower than younger patients. Compared with men, women had worse health status before the intervention measured with both HRQoL tools. In the unadjusted analysis women had greater improvements than men, measured by the GIQLI, but not with the SF-36. However, after controlling for other relevant variables, the SF-36 measured lower improvements in women more often than men, but the GIQLI showed similar results for both. For men and women, the lower the pre-intervention health status the higher the post-operative improvement. Women presented with worse health status before the intervention and less improvement post-operatively after adjustments. The pre-intervention health status has an important role explaining changes after the intervention. A gender-related difference exists between what a generic and a disease-specific HRQoL instrument captures when measuring HRQoL improvement after cholecystectomy.

Long-term outcomes of laparoscopic cholecystectomy: a prospective piecewise linear regression analysis

“…Quintana et al [14] suggested that men with low surgical risk are more likely to receive a diagnosis of complicated cholelithiasis than men with high surgical risk and are therefore more likely to exhibit larger increases in HRQoL. Therefore, the gender difference in HRQoL outcomes apparently reflects the treatment of patients with less complicated presentations, which may indicate that the disease has a smaller impact on the HRQoL of these patients.…”

The minimal clinically important difference in the Gastrointestinal Quality-of-Life Index after cholecystectomy

“…First, global ratings of change require patients to compare their symptoms, emotions, physical functions, and social functions retrospectively before and after cholecystectomy surgery, and these retrospective self-reports are known to be subject to recall bias [15]. Health researchers have proposed prospective anchors that merit further study [16]. When using a prospective anchor, patients rate their symptoms, emotions, physical functions, and social functions at two sequential time intervals as mild, moderate, moderately severe, severe, very severe, or unbearable.…”

Long-term quality of life after endoscopic dilation of strictured colorectal or colocolonic anastomoses

“…This alteration in HRQoL was relatively severe because total GIGLI scores reported by study patients were close to those reported in various conditions for which surgery is recommended (e.g., diseases of the GI or biliopancreatic tract) [14,21]. Abnormal GI symptoms included abdominal pain, alterations in bowel movements, gas bloat, and restriction of food intake.…”