Top

Published in:

Open Access 01-12-2007 | Research

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

Authors: Kimberly R Boer, Oddeke van Ruler, Johannes B Reitsma, Cecilia W Mahler, Brent C Opmeer, E Ascelijn Reuland, Hein G Gooszen, Peter W de Graaf, Eric J Hesselink, Michael F Gerhards, E Philip Steller, Mirjam A Sprangers, Marja A Boermeester, Corianne A De Borgie, The Dutch Peritonitis Study Group

Published in: Health and Quality of Life Outcomes | Issue 1/2007

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.

Available only for authorised users

Christou NV, Barie PS, Dellinger EP, Waymack JP, Stone HH: Surgical Infection Society intra-abdominal infection study. Prospective evaluation of management techniques and outcome. Arch Surg 1993, 128: 193–198.PubMedCrossRef

Koperna T, Schulz F: Prognosis and treatment of peritonitis. Do we need new scoring systems? Arch Surg 1996, 131: 180–186.PubMedCrossRef

Wittmann DH, Schein M, Condon RE: Management of secondary peritonitis. Ann Surg 1996, 224: 10–18. 10.1097/00000658-199607000-00003PubMedCentralPubMedCrossRef

Haraldsen P, Andersson R: Quality of life, morbidity, and mortality after surgical intensive care: a follow-up study of patients treated for abdominal sepsis in the surgical intensive care unit. Eur J Surg Suppl 2003, 23–27.

Lamme B, Boermeester MA, Belt EJ, van Till JW, Gouma DJ, Obertop H: Mortality and morbidity of planned relaparotomy versus relaparotomy on demand for secondary peritonitis. Br J Surg 2004, 91: 1046–1054. 10.1002/bjs.4517PubMedCrossRef

Slade E, Tamber PS, Vincent JL: The Surviving Sepsis Campaign: raising awareness to reduce mortality. Crit Care 2003, 7: 1–2. 10.1186/cc1876PubMedCentralPubMedCrossRef

Quartin AA, Schein RM, Kett DH, Peduzzi PN: Magnitude and duration of the effect of sepsis on survival. Department of Veterans Affairs Systemic Sepsis Cooperative Studies Group. JAMA 1997, 277: 1058–1063. 10.1001/jama.277.13.1058PubMedCrossRef

Brun-Buisson C, Doyon F, Carlet J, Dellamonica P, Gouin F, Lepoutre A, Mercier JC, Offenstadt G, Regnier B: Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA 1995, 274: 968–974. 10.1001/jama.274.12.968PubMedCrossRef

Pittet D, Rangel-Frausto S, Li N, Tarara D, Costigan M, Rempe L, Jebson P, Wenzel RP: Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock: incidence, morbidities and outcomes in surgical ICU patients. Intensive Care Med 1995, 21: 302–309. 10.1007/BF01705408PubMedCrossRef

10.

Alberti C, Brun-Buisson C, Goodman SV, Guidici D, Granton J, Moreno R, Smithies M, Thomas O, Artigas A, Le Gall JR: Influence of systemic inflammatory response syndrome and sepsis on outcome of critically ill infected patients. Am J Respir Crit Care Med 2003, 168: 77–84. 10.1164/rccm.200208-785OCPubMedCrossRef

11.

Granja C, Dias C, Costa-Pereira A, Sarmento A: Quality of life of survivors from severe sepsis and septic shock may be similar to that of others who survive critical illness. Crit Care 2004, 8: R91-R98. 10.1186/cc2818PubMedCentralPubMedCrossRef

12.

Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001, 29: 1303–1310. 10.1097/00003246-200107000-00002PubMedCrossRef

13.

McLauchlan GJ, Anderson ID, Grant IS, Fearon KC: Outcome of patients with abdominal sepsis treated in an intensive care unit. Br J Surg 1995, 82: 524–529. 10.1002/bjs.1800820429PubMedCrossRef

14.

Bosscha K, Reijnders K, Jacobs MH, Post MW, Algra A, van der WC: Quality of life after severe bacterial peritonitis and infected necrotizing pancreatitis treated with open management of the abdomen and planned re-operations. Crit Care Med 2001, 29: 1539–1543. 10.1097/00003246-200108000-00007PubMedCrossRef

15.

Sloan JA, Cella D, Frost MH, Guyatt G, Osoba D: Quality of life III: translating the science of quality-of-life assessment into clinical practice-an example-driven approach for practicing clinicians and clinical researchers. Clin Ther 2003, 25 Suppl D: D1-D5. 10.1016/S0149-2918(03)80244-8PubMedCrossRef

16.

Scheingraber S, Kurz T, Dralle H: Short- and long-term outcome and health-related quality of life after severe peritonitis. World J Surg 2002, 26: 667–671. 10.1007/s00268-001-0287-xPubMedCrossRef

17.

Juergensen PH, Juergensen DM, Wuerth DB, Finkelstein SH, Steele TE, Kliger AS, Finkelstein FO: Psychosocial factors and incidence of peritonitis. Adv Perit Dial 1996, 12: 196–198.PubMed

18.

Essink-Bot ML, Stouthard ME, Bonsel GJ: Generalizability of valuations on health states collected with the EuroQolc-questionnaire. Health Econ 1993, 2: 237–246. 10.1002/hec.4730020307PubMedCrossRef

19.

Brooks R, Kerridge R, Hillman K, Bauman A, Daffurn K: Quality of life outcomes after intensive care. Comparison with a community group. Intensive Care Med 1997, 23: 581–586. 10.1007/s001340050376PubMedCrossRef

20.

Dowdy DW, Eid MP, Sedrakyan A, Mendez-Tellez PA, Pronovost PJ, Herridge MS, Needham DM: Quality of life in adult survivors of critical illness: A systematic review of the literature. Intensive Care Med 2005, 31: 611–620. 10.1007/s00134-005-2592-6PubMedCrossRef

21.

Slevin ML, Plant H, Lynch D, Drinkwater J, Gregory WM: Who should measure quality of life, the doctor or the patient? Br J Cancer 1988, 57: 109–112.PubMedCentralPubMedCrossRef

22.

Badia X, Diaz-Prieto A, Rue M, Patrick DL: Measuring health and health state preferences among critically ill patients. Intensive Care Med 1996, 22: 1379–1384. 10.1007/BF01709554PubMedCrossRef

23.

Angus DC, Carlet J: Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 2003, 29: 368–377.PubMed

24.

Brooks R, Rabin R, de Charro F, (Eds): The Measurement and Valuation of Health Status using EQ-5D: A European Perspective; Evidence from the EuroQol BIOMED Research Programme. Edited by: Brooks R, R R and de Charro F. Dordrecht, Kluwer Academic Publishers; 2003.

25.

EQ-5D, An instrument to describe and value health. 2007. [http://www.euroqol.org]

26.

Roset M, Badia X, Mayo NE: Sample size calculations in studies using the EuroQol 5D. Qual Life Res 1999, 8: 539–549. 10.1023/A:1008973731515PubMedCrossRef

27.

Brooks R: EuroQol: the current state of play. Health Policy 1996, 37: 53–72. 10.1016/0168-8510(96)00822-6PubMedCrossRef

28.

Hurel D, Loirat P, Saulnier F, Nicolas F, Brivet F: Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and a satisfaction scale. Intensive Care Med 1997, 23: 331–337. 10.1007/s001340050336PubMedCrossRef

29.

Tian ZM, Miranda DR: Quality of life after intensive care with the sickness impact profile. Intensive Care Med 1995, 21: 422–428. 10.1007/BF01707411PubMedCrossRef

30.

Rockwood K, Noseworthy TW, Gibney RT, Konopad E, Shustack A, Stollery D, Johnston R, Grace M: One-year outcome of elderly and young patients admitted to intensive care units. Crit Care Med 1993, 21: 687–691. 10.1097/00003246-199305000-00011PubMedCrossRef

31.

Boer KR, Mahler CW, Unlu C, Lamme B, Vroom MB, Sprangers MA, Gouma DJ, Reitsma JB, De Borgie CA, Boermeester MA: Long-term prevalence of posttraumatic stress disorder symptoms in patients after secondary peritonitis. Crit Care 2007, 11: R30. 10.1186/cc5710PubMedCentralPubMedCrossRef

32.

Badia X, Diaz-Prieto A, Gorriz MT, Herdman M, Torrado H, Farrero E, Cavanilles JM: Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 2001, 27: 1901–1907. 10.1007/s00134-001-1137-xPubMedCrossRef

33.

Garcia-Lizana F, Peres BD, De Cubber M, Vincent JL: Long-term outcome in ICU patients: what about quality of life? Intensive Care Med 2003, 29: 1286–1293. 10.1007/s00134-003-1875-zPubMedCrossRef

34.

Koperna T, Semmler D, Marian F: Risk stratification in emergency surgical patients: is the APACHE II score a reliable marker of physiological impairment? Arch Surg 2001, 136: 55–59. 10.1001/archsurg.136.1.55PubMedCrossRef

35.

Bohnen JM, Mustard RA, Oxholm SE, Schouten BD: APACHE II score and abdominal sepsis. A prospective study. Arch Surg 1988, 123: 225–229.PubMedCrossRef

36.

Wehler M, Geise A, Hadzionerovic D, Aljukic E, Reulbach U, Hahn EG, Strauss R: Health-related quality of life of patients with multiple organ dysfunction: individual changes and comparison with normative population. Crit Care Med 2003, 31: 1094–1101. 10.1097/01.CCM.0000059642.97686.8BPubMedCrossRef

37.

Granja C, Teixeira-Pinto A, Costa-Pereira A: Quality of life after intensive care--evaluation with EQ-5D questionnaire. Intensive Care Med 2002, 28: 898–907. 10.1007/s00134-002-1345-zPubMedCrossRef

38.

RM Kleinpell: Exploring outcomes after critical illness in the elderly. Outcomes Manag 2003, 7: 159–169.

39.

Vedio AB CS Warburton FG,Griffiths MP,Leach RM,Treacher DF: Assessment of survival and quality of life after discharge from a teaching hospital general intensive care unit. Clin Intensive Care 2000, 11: 39–46. 10.1080/714028679CrossRef

40.

Pettila V, Kaarlola A, Makelainen A: Health-related quality of life of multiple organ dysfunction patients one year after intensive care. Intensive Care Med 2000, 26: 1473–1479. 10.1007/s001340000629PubMedCrossRef

41.

Graf J, Koch M, Dujardin R, Kersten A, Janssens U: Health-related quality of life before, 1 month after, and 9 months after intensive care in medical cardiovascular and pulmonary patients. Crit Care Med 2003, 31: 2163–2169. 10.1097/01.CCM.0000079607.87009.3APubMedCrossRef

42.

Kvale R, Flaatten H: Changes in health-related quality of life from 6 months to 2 years after discharge from intensive care. Health Qual Life Outcomes 2003, 1: 2. 10.1186/1477-7525-1-2PubMedCentralPubMedCrossRef

43.

Sage WM, Rosenthal MH, Silverman JF: Is intensive care worth it? An assessment of input and outcome for the critically ill. Crit Care Med 1986, 14: 777–782. 10.1097/00003246-198609000-00004PubMedCrossRef

44.

Stricker KH, Cavegn R, Takala J, Rothen HU: Does ICU length of stay influence quality of life? Acta Anaesthesiol Scand 2005, 49: 975–983. 10.1111/j.1399-6576.2005.00702.xPubMedCrossRef

45.

Dowie J: Decision validity should determine whether a generic or condition-specific HRQOL measure is used in health care decisions. Health Econ 2002, 11: 1–8. 10.1002/hec.667PubMedCrossRef

Title: Health related quality of life six months following surgical treatment for secondary peritonitis – using the EQ-5D questionnaire
Authors: Kimberly R Boer
Oddeke van Ruler
Johannes B Reitsma
Cecilia W Mahler
Brent C Opmeer
E Ascelijn Reuland
Hein G Gooszen
Peter W de Graaf
Eric J Hesselink
Michael F Gerhards
E Philip Steller
Mirjam A Sprangers
Marja A Boermeester
Corianne A De Borgie
The Dutch Peritonitis Study Group
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2007
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-5-35

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Design

Setting

Patients

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Design

Setting

Patients

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2007

Impairment of quality of life in parents of children and adolescents with pervasive developmental disorder

Validity and reliability of the Spanish version of the DN4 (Douleur Neuropathique 4 questions) questionnaire for differential diagnosis of pain syndromes associated to a neuropathic or somatic component

Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes

Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control

Health-related quality of life of child and adolescent retinoblastoma survivors in the Netherlands