The impact of complications on quality of life following colorectal surgery: A prospective cohort study to evaluate the Clavien-Dindo classification system

E. Bosma, M.J.J. Pullens, J. de Vries, J.A. Roukema

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aim
This prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien–Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures.
Method
Patients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression.
Results
Of 218 patients, 130 (59.6%) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho −0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks.
Conclusion
Severe complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC.
Original languageEnglish
Pages (from-to)594–602
JournalColorectal Disease
Volume18
Issue number6
DOIs
Publication statusPublished - 2016

Fingerprint

Colorectal Surgery

Cite this

@article{d762507a0bc64bb5868f341819fafe59,
title = "The impact of complications on quality of life following colorectal surgery: A prospective cohort study to evaluate the Clavien-Dindo classification system",
abstract = "AimThis prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien–Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures.MethodPatients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression.ResultsOf 218 patients, 130 (59.6{\%}) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho −0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks.ConclusionSevere complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC.",
author = "E. Bosma and M.J.J. Pullens and {de Vries}, J. and J.A. Roukema",
year = "2016",
doi = "10.1111/codi.13244",
language = "English",
volume = "18",
pages = "594–602",
journal = "Colorectal Disease",
issn = "1462-8910",
publisher = "Wiley-Blackwell",
number = "6",

}

The impact of complications on quality of life following colorectal surgery : A prospective cohort study to evaluate the Clavien-Dindo classification system. / Bosma, E.; Pullens, M.J.J.; de Vries, J.; Roukema, J.A.

In: Colorectal Disease, Vol. 18, No. 6, 2016, p. 594–602.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The impact of complications on quality of life following colorectal surgery

T2 - A prospective cohort study to evaluate the Clavien-Dindo classification system

AU - Bosma, E.

AU - Pullens, M.J.J.

AU - de Vries, J.

AU - Roukema, J.A.

PY - 2016

Y1 - 2016

N2 - AimThis prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien–Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures.MethodPatients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression.ResultsOf 218 patients, 130 (59.6%) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho −0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks.ConclusionSevere complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC.

AB - AimThis prospective cohort study was performed to evaluate the impact of complications on quality of life (QOL) in colorectal surgery. The Clavien–Dindo complication classification (CDCC) is promising, but has not been evaluated by relating the classification to patient-reported outcome measures.MethodPatients undergoing colorectal surgery were evaluated prospectively 12 months postoperatively using the WHOQOL-BREF questionnaire. Patient data were prospectively recorded and complications were classified using the CDCC. Postoperative QOL in patients with minor and severe complications and patients without complications was compared using a general linear model. Relationships between CDCC and QOL were examined using correlations and multivariate regression.ResultsOf 218 patients, 130 (59.6%) had complications. In patients with severe complications there was a greater decrease in overall QOL (P = 0.043), QOL-physical (P < 0.001) and QOL-psychological (P = 0.013) domains in the first six postoperative weeks, whereas patients with minor complications had QOL scores comparable to those of patients without complications. QOL recovered to preoperative levels in all groups at 12 months. Change in QOL at 6 weeks was significantly correlated with CDCC grade, especially in the physical domain (Spearman's rho −0.287, P < 0.001). The presence of severe complications was an independent predictor of overall QOL, QOL-physical and QOL-psychological at 6 weeks.ConclusionSevere complications are associated with reduced postoperative QOL at 6 weeks, but QOL recovers after 12 months. CDCC grade negatively correlates with change in QOL in the early postoperative period. These findings support the theoretical framework of the CDCC.

U2 - 10.1111/codi.13244

DO - 10.1111/codi.13244

M3 - Article

VL - 18

SP - 594

EP - 602

JO - Colorectal Disease

JF - Colorectal Disease

SN - 1462-8910

IS - 6

ER -