Health related quality of life six months following surgical treatment for secondary peritonitis--using the EQ-5D questionnaire

Abstract

Background: To compare health related quality of life (HR-QoL) in patients surgically treated for secondary peritonitis to that of a healthy population. And to prospectively identify factors associated with poorer (lower) HR-QoL.

Design: A prospective cohort of secondary peritonitis patients was mailed the EQ-5D and EQ-VAS 6-months following initial laparotomy.

Setting: Multicenter study in two academic and seven regional teaching hospitals.

Patients: 130 of the 155 eligible patients (84%) responded to the HR-QoL questionnaires.

Results: HR-QoL was significantly worse on all dimensions in peritonitis patients than in a healthy reference population. Peritonitis characteristics at initial presentation were not associated with HR-QoL at six months. A more complicated course of the disease leading to longer hospitalization times and patients with an enterostomy had a negative impact on the mobility (p = 0.02), self-care (p < 0.001) and daily activities: (p = 0.01). In a multivariate analysis for the EQ-VAS every doubling of hospital stay decreases the EQ-VAS by 3.8 points (p = 0.015). Morbidity during the six-month follow-up was not found to be predictive for the EQ-5D or EQ-VAS.

Conclusion: Six months following initial surgery, patients with secondary peritonitis report more problems in HR-QoL than a healthy reference population. Unfavorable disease characteristics at initial presentation were not predictive for poorer HR-QoL, but a more complicated course of the disease was most predictive of HR-QoL at 6 months.

Figure 1

Flowchart summarizing inclusion and response.

Figure 2

Percentage of HR-QoL problems reported by peritonitis study patients (n = 130) compared to a general reference population from The Netherlands (Dutch reference population) (n = 851) [18] by EQ-5D dimensions.