Predictors of quality-of-life after ileal pouch-anal anastomosis in patients with ulcerative colitis

Abolfotouh, Sherif; Rautio, Tero; Klintrup, Kai; Helavirta, Ilona; Mäkelä, Jyrki

doi:10.1080/00365521.2017.1337218

Cited by 12 publications

(7 citation statements)

References 26 publications

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“…Impaired pouch function has been shown to be associated with anxiety 37 and low QoL, 2,15 and this was confirmed in the present study. The factors affecting QoL in this study, similar to other studies, were sleep quality, 38 ability to work, 29,37 and sexual function. 29,38 Patients with worse pouch function also had more negative beliefs about their condition and their ability to manage it well.…”

Section: Discussionsupporting

confidence: 89%

“…The median PDS score was 1.25 (range 0-7.5) and was strongly positively correlated with the COREFO score (r = 0.82 [P < 0.0001]). The median score and interquartile range (IQR) for the COREFO domains were incontinence 15 , impact 19 , frequency 38 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38), stool-related aspects 17 , and medication 33 .…”

Section: Resultsmentioning

confidence: 99%

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Determinants of long‐term function and general well‐being in patients with an ileoanal pouch

et al. 2020

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Background and aim: Fecal incontinence and/or evacuation difficulty are common after ileoanal pouch surgery. This study aimed to determine whether the development of these symptoms can be predicted so that preventive measures might be instituted. Methods: A consecutive series of 46 patients with ulcerative colitis (median age at surgery, 41 years; 50% female) and a functioning pouch for a duration ≥12 months was included. Assessment utilized medical record review and questionnaires on preand postoperative bowel function, quality of life, and psychological well-being. Pouch function was assessed by the Colorectal Functional Outcome score (0 = no impairment, 100 = worst impairment). Good pouch function was defined as a score ≤24. Results: Fecal incontinence occurred in 67% preoperatively and 54% postoperatively; evacuation difficulty occurred in 65% and preoperatively and 85% postoperatively. The postoperative median Colorectal Functional Outcome score was 20 (range 2-74), with 44% of patients >24 (poor pouch function). Preoperative nocturnal fecal incontinence (odds ratio [OR] 4.92, 95% confidence interval [CI] 1.2-19.4, P = 0.02) and pouchitis (OR 5.41, 95% CI 1.2-23.7, P = 0.02) were associated with poor pouch function after multivariable regression analysis. Postoperative satisfaction, psychological well-being, and quality of life were significantly better in those with good pouch function, while poor sleep, impaired work, and sexual dysfunction were independently associated with poor pouch function. Conclusions: Functional bowel symptoms are common before and after pouch surgery and are associated with the impairment of patient-reported outcomes. Preoperative nocturnal fecal incontinence predicts poor pouch function. Therapeutic focus on continence, bowel evacuation, psychological well-being, and quality of life should begin before surgery.

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Section: Discussionsupporting

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Determinants of long‐term function and general well‐being in patients with an ileoanal pouch

et al. 2020

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“… 27 Although colectomy may be life-saving, it was recommended not to be considered a cure for UC. 28 Patients undergoing colectomy can still experience poor HRQoL, 29–31 anxiety and depression, problems with body image and sexual function, and decreased productivity. 32 Approximately one-third of patients having UC-related surgery experience some form of postoperative complications 33 ; and these can result in substantial humanistic and economic burden.…”

Section: Introductionmentioning

confidence: 99%

Living with Ulcerative Colitis Study (LUCY) in England: a retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitis

Brookes

Waller

Cappelleri

et al. 2020

BMJ Open Gastroenterol

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ObjectiveUlcerative colitis (UC) is a lifelong, relapsing-remitting disease. Patients non-responsive to pharmacological treatment may require a colectomy. We estimated pre-colectomy and post-colectomy healthcare resource utilisation (HCRU) and costs in England.Design/MethodA retrospective, longitudinal cohort study indexing adult patients with UC undergoing colectomy (2009–2015), using linked Clinical Practice Research Datalink/Hospital Episode Statistics data, was conducted. HCRU, healthcare costs and pharmacological treatments were evaluated during 12 months prior to and including colectomy (baseline) and 24 months post-colectomy (follow-up; F-U), comparing baseline/F-U, emergency/elective colectomy and subtotal/full colectomy using descriptive statistics and paired/unpaired tests.Results249 patients from 26 165 identified were analysed including 145 (58%) elective and 184 (74%) full colectomies. Number/cost of general practitioner consultations increased post-colectomy (p<0.001), and then decreased at 13–24 months (p<0.05). From baseline to F-U, the number of outpatient visits, number/cost of hospitalisations and total direct healthcare costs decreased (all p<0.01). Postoperative HCRU was similar between elective and emergency colectomies, except for the costs of colectomy-related hospitalisations and medication, which were lower in the elective group (p<0.05). Postoperative costs were higher for subtotal versus full colectomies (p<0.001). At 1–12 month F-U, 30%, 19% and 5% of patients received aminosalicylates, steroids and immunosuppressants, respectively.ConclusionHCRU/costs increased for primary care in the first year post-colectomy but decreased for secondary care, and varied according to the colectomy type. Ongoing and potentially unnecessary pharmacological therapy was seen in up to 30% of patients. These findings can inform patients and decision-makers of potential benefits and burdens of colectomy in UC.

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“…In a recent Finnish multicentre study HRQoL was impaired compared to the general population. This study also aimed to identify factors for poor outcome and found older age at time of operation and preoperative hypertension to be significant predictors (21). In this study, most (n = 131,70.1%) of the RPC patients had well-functioning pouch.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life after Restorative Proctocolectomy: A Cross-Sectional Study

et al. 2018

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Predictors of quality-of-life after ileal pouch-anal anastomosis in patients with ulcerative colitis

Cited by 12 publications

References 26 publications

Determinants of long‐term function and general well‐being in patients with an ileoanal pouch

Determinants of long‐term function and general well‐being in patients with an ileoanal pouch

Living with Ulcerative Colitis Study (LUCY) in England: a retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitis

Health-Related Quality of Life after Restorative Proctocolectomy: A Cross-Sectional Study

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