EFFECT OF SURGERY ON HEALTH-RELATED QUALITY-OF-LIFE IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE - A PROSPECTIVE-STUDY

Background: Health-related quality of life (HRQL) has increasingly bec ome a factor in management decisions in patients with chronic diseases . Objective: To measure the effect of surgical resection on quality of life in patients with inflammatory bowel disease (IBD). Design: A con secutive series of patients undergoing surgery for IBD between June 19 94 and December 1997 were prospectively investigated as a cohort outco mes study. Patients: Data were obtained in 63 patients. The primary di agnoses were Crohn's disease (n = 36) and ulcerative colitis (n = 27). Intervention: Patients with Crohn's disease underwent resection with or without stricturoplasty for intractable disease; all but 3 patients with ulcerative colitis underwent ileoanal anastomoses with ileoanal reservoir. Main Outcome Measure: Health status was measured using the Health Status Questionnaire preoperatively and every 3 months postoper atively. Results: Preoperative measures of HRQL of the patients were l ow, with values well below the general population in all 8 scales of t he Health Status Questionnaire. Postoperatively, HRQL measures improve d significantly (P<.05) in both patients with Crohn's disease and thos e with ulcerative colitis, with scores equal to the general population in most scales. For example, average raw scores for general health in previously studied patient groups were 59 in patients with asthma, 55 in those with diabetes mellitus, 74 in the general population, and 54 and 73 preoperatively and postoperatively, respectively, in the prese nt study. Conclusions: The results of this study confirm that HRQL sco res are low in many patients with IBD referred for operation and HRQL scores improve postoperatively to levels comparable to those of the ge neral population. We believe these data justify early surgical interve ntion in many patients with symptomatic IBD.