Subjective assessment of quality of life, pain and surgical success after laparotomy for Crohn disease
Post, S.; Kunhardt, M.; Herfarth, C.
Der Chirurg; Zeitschrift für Alle Gebiete der Operativen Medizen 66(8): 800-806
1995
ISSN/ISBN: 0009-4722 PMID: 7587544 Document Number: 444010
239 patients following major surgery for Crohn's disease (mean 8 years after first operation) were interviewed by mailed questionnaire. Main target parameters included reduction of quality of life, intensity/frequency of abdominal pain, and grading of success of the most recent operation for Crohn's disease. These targets were correlated in univariate as well as multivariate statistics with 28 different parameters of general medical history, surgical pretreatment, actual somatic and psychosocial findings. Reduction of quality of life correlated with stool frequency, employment status, rectal involvement, hematochezia, liquid stools, extraintestinal manifestations and time since first operation (all with p < 0.05 in multivariate analysis; listed in decreasing levels of significance). Abdominal pain at time of interview was significantly associated with actual intake of corticosteroids, stool frequency, employment status, extraintestinal manifestations, dietary restrictions, and number of previous operations (other than laparotomies). Regarding success of most recent laparotomy important parameters included stool frequency, intake of corticosteroids, number of previous laparotomies, hematochezia, and history of enterostomy. Overall, parameters of disease activity were found to be more important than characteristics of medical history or previous surgery. Despite marked symptoms in many cases 92% of the patients regarded the most recent laparotomy to be fully or partially successful. The results provide direct and indirect evidence that besides momentary disease activity the individual personality profile may be far more important than type and number of previous surgery in coping with this chronic disease.