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American Journal of Surgery

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Comorbidities play a larger role in predicting health-related quality of life compared to having an ostomy - 21/08/11

Doi : 10.1016/j.amjsurg.2007.08.020 
Sushma Jain, M.P.H. a, ⁎ , Marcia L. McGory, M.D. a, Clifford Y. Ko, M.D. a, b, Alla Sverdlik, M.P.H. a, James S. Tomlinson, M.D. a, b, Christopher S. Wendel, M.S. c, Stephen Joel Coons, Ph.D. d, e, Susan M. Rawl, Ph.D. f, C. Max. Schmidt, M.D. g, Marcia Grant, D.N.Sc. h, Ruth McCorkle, Ph.D. i, M. Jane Mohler, Ph.D. c, d, e, j, Carol M. Baldwin, Ph.D. k, Robert S. Krouse, M.D. c, j
a Center for Surgical Outcomes and Quality, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA 
b Department of Surgery, Greater West Los Angeles VA Healthcare System, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA 
c Southern Arizona Veterans Affairs Health Care System, Research Service Line, 0-151, 3601 S. 6th Ave, Tucson, AZ 85723, USA 
d University of Arizona College of Public Health, 1295 N. Martin Ave, POB 210202, Tucson, AZ 85721-0202, USA 
e University of Arizona College of Pharmacy, Drachman Hall Room b307, 1295 N. Martin Ave, POB 210202, Tucson, AZ 85721-0202, USA 
f Indiana University School of Nursing, Center for Nursing Research, 1111 Middle Drive, NU 340-C, Indianapolis, IN 46202-5107, USA 
g Richard L. Roudebush VA Medical Center, Indiana University School of Medicine, Department of Surgery and Biochemistry/Molecular Biology, Cancer Research Institute (R4) Rm 039, 1044, W. Walnut St, Indianapolis, IN 46202-5254, USA 
h City of Hope National Medical Center/Beckman Research Institute, Department of Nursing Research and Education, 1500 East Duarte Rd, Duarte, CA 91010-3000, USA 
i Yale University School of Nursing, 100 Church St. South, POB 9740, New Haven, CT 06536, USA 
j University of Arizona College of Medicine, Health Services Research Center Surgical Care Line, 2-112, 3601 S. 6th Ave, Tucson, AZ 85723, USA 
k Arizona State University, College of Nursing and Healthcare Innovation (Southwest Borderlands), 500 N. 3rd St, Phoenix, AZ 85004-0698, USA 

Corresponding author. David Geffen School of Medicine at UCLA, Department of Surgery, 72-215 CHS, 10833 Le Conte Ave., Los Angeles, CA 90095. Tel.: +1-310-478-3711 ext. 42830; fax: +1-310-268-4601.

Abstract

Background

Previous research suggests an ostomy worsens health-related quality of life (HR-QOL), but comorbidities also can affect HR-QOL.

Methods

Eligible patients had abdominal operation with ostomy (cases) or similar procedure without ostomy (controls). Patients were recruited for this case-control study from 3 Veterans Affairs hospital medical and pharmacy records. Comorbidities were assessed with Charlson-Deyo Comorbidity Index. Multinomial logistic regression evaluated the impact of comorbidities and having an ostomy on HR-QOL, measured using the Medical Outcomes Study Short Form 36 for Veterans.

Results

A total of 237 ostomates (cases) and 268 controls were studied. Average age was 69 years; 64% of cases had colostomy, 36% ileostomy. Twenty-nine percent of patients had a high level of comorbidities. Cases and controls were similar except for reasons for undergoing surgery. High comorbidity was a significant predictor of low HR-QOL in 6 domains of the Short Form 36 for Veterans; having an ostomy was a significant predictor in 4.

Conclusions

High comorbidity significantly influences low HR-QOL and impacted more domains than having an ostomy.

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Keywords : Comorbidites, Ostomy, Health-related quality of life


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Vol 194 - N° 6

P. 774-779 - décembre 2007 Regresar al número
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