Abstract
Improvement of health-related quality of life(HRQOL) is a major determinant in decisionmaking forsurgery in patients with Crohn's disease (CD). Thisstudy was designed to investigate the short- andlong-term effect of surgical resection for CD on HRQOL.Sixteen patients were investigated within one weekbefore surgery and 3, 6, and 24 months postoperatively.Besides the Crohn's disease activity index (CDAI), four instruments: the time trade-off technique(TTO), the direct questioning of objectives (DQO), therating form of inflammatory bowel disease patientsconcerns (RFIPC), and the Beck depression inventory-were used for assessment of HRQOL. CDAI decreasedsignificantly after operation and 10 patients remainedin remission for 24 months. Two patients hadpostoperative relapses and went into remission afterprednisolone treatment. Four patients developed chronicactive disease. HRQOL was significantly improved in allpatients three and six months postoperatively. Exceptfor the four patients with chronic active disease, all other patients (N = 12) had alsosignificantly improved HRQOL after 24 months. Inconclusion, surgical resections in CD lead to along-term improvement of HRQOL with the exception ofpatients with chronic active disease. This finding might be taken inconsideration for the indication of surgery inCD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Gazzard BG, Price HL, Libby GW, Dawson AM: The social toll of Crohn' s disease. Br Med J 2:1117–1119, 1978
Sørensen VZ, Olsen BG, Binder V: Life prospects and quality of life in patients with Crohn' s disease. Gut 28:382–385, 1987
Drossman DA, Leserman J, Mitchell CM, Li Z, Zagami EA, Patrick DL: Health status and health care use in persons with inflammatory bowel disease. A national sample. Dig Dis Sci 12:1746–1755, 1991
Broe PJ, Bayless TM, Cameron JL: Crohn's disease: Are enteroenteral fistulas an indication for surgery? Surgery 91:249–258, 1982
Shivananda S, Hordijk ML, Pena AS, Mayberry JF: Crohn' s disease: Risk of recurrence and reoperation in a defined population. Gut 30:990–995, 1989
Whelan G, Farmer RG, Fazio VW, Goormastic M: Recurrence after surgery in Crohn' s disease. Gastroenterology 88:1826–1833, 1985
Agrez MV, Valente RM, Pierce W, Melton LJ, van Heerden JA, Beart RW: Surgical history of Crohn's disease in a welldefined population. Mayo Clin Proc 57:747–752, 1982
Glotzer JD: Surgical therapy for Crohn's disease. Gastroenterol Clin North Am 24:577–596, 1995
Meyers S, W alfish JS, Sachar DB, Greenstein AJ, Hill AG, Janowitz HD: Quality of life after surgery for Crohn's disease: A psychosocial survey. Gastroenterology 78:1–6, 1980
Scott NA, Hughes LE: Timing of ileocolonic resection for symptomatic Crohn's disease—the patient's view. Gut 35:656–657, 1994
Shivananda S, van Blankenstein M, Schouten WR: Quality of life in Crohn' s disease: Results of a case- control study. Gastroenterology A 2150
Drossman D: Psychosocial considerations in gastroenterology, In Gastrointestinal Disease: Pathophysiology, Diagnosis and Management, 5th ed. MH Sleisanger, JS Fordtran (eds). Philadelphia, WB Saunders, 1993
Yazdanpanah Y, Klein O, Gambiez L, Baron P, Desreumaux P, Marquis P, Cortot A, Quandalle, Colombel J-F: Impact of surgery on quality of life in Crohn' s disease. AJG 92:1897–1900, 1997
Torrance GW, Thomas WH, Sackett DL: A utility maximation model for evaluation of health care program. Health Serv Res 7:118–133, 1972
Mohide EA, Torrance GW, Streiner DL, Pringle DM, Gilbert R: Measuring the wellbeing of family caregivers using the time trade-off technique. J Clin Epidemiol 41:475–482, 1988
Detsky AS, McLaughlin Jr, Abrams HB, L'Abbe KA, Withwell J, Bombardier C, Jeejeebhoy KN: Quality of life of patients on long-term parenteral nutrition at home. J Gen Intern Med 1:26–33, 1986
McLeod RS, Churchill DN, Lock AM, Cohen Z: Quality of life of patients with ulcerative colitis preoperatively and postoperatively. Gastroenterology 101:1307–1313, 1991
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry 4:561–571, 1961
Drossman DA, Leserman J, Li Z, Mitchell M, Zagami EA, Patrick DL: The rating form of IBD patient concerns: A new measure of health status. Psychsom Med 53:701–712, 1991
Provenzale D, Shearin M, Phillips-Bute BG, Drossman DA, Li ZM, Tillinger W, Schmitt CM, Bollinger RR, Koruda MJ: Health-related quality of life after ileoanal pull-through: Evaluation and assessment of new health status measures. Gastroenterology 113:7–14, 1997
Best WR, Bechtel JM, Singleton JWW, Kern FJ: Development of a Crohn' s disease activity index. National Cooperative Crohn's Disease Study. Gastroenterology 70:439–444, 1976
Dorda W, Laminger B, Reichetseder CH, Sachs P: Computereinsatz zur Analyse medizinischer Daten-Die Auswertungssysteme WAMAS und WAMASTAT. In WAMIS Wiener allgemeines Medizinisches Informations-System G Grabner (ed). Berlin, Springer-Verlag, 1985, pp 251–291
Stange EF, Schreiber S, Raedler A, Stallmach A, Schölmerich J, Loeschke K, Starlinger M, Fischbach W, Caspary WF: Therapie des Morbus Crohn-Ergebnisse e iner Konsensuskonferenz der Deutschen Ge se llschaft für Verdauungs-und Stoffwechse lkrankheiten. Z Gastroenterol 35:541–554, 1997
Moser G, Tillinger W, Sachs G, Genser D, Maier-Dobersberger T, Spiess K, Wyatt J, Vogelsang H, Lochs H, Gangl A: Disease-related worries and concerns: a study on out-patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 7:853–859, 1995
Rights and permissions
About this article
Cite this article
Tillinger, W., Mittermaier, C., Lochs, H. et al. Health-Related Quality of Life in Patients with Crohn's Disease (Influence of Surgical Operation-A Prospective Trial). Dig Dis Sci 44, 932–938 (1999). https://doi.org/10.1023/A:1026600428484
Issue Date:
DOI: https://doi.org/10.1023/A:1026600428484