Research

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

Kimberly R Boer¹ , Oddeke van Ruler² , Johannes B Reitsma¹ , Cecilia W Mahler² , Brent C Opmeer¹ , E Ascelijn Reuland² , Hein G Gooszen³ , Peter W de Graaf⁴ , Eric J Hesselink⁵ , Michael F Gerhards⁶ , E Philip Steller⁷ , Mirjam A Sprangers⁸ , Marja A Boermeester² , Corianne A De Borgie¹ and The Dutch Peritonitis Study Group⁹

¹  Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands

²  Department of Surgery, Academic Medical Center Amsterdam, The Netherlands

³  Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

⁴  Department of Surgery, Reinier de Graaf Hospital, Delft, The Netherlands

⁵  Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands

⁶  Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

⁷  Department of Surgery, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands

⁸  Department of Medical Psychology, Academic Medical Center Amsterdam, The Netherlands

⁹  Department of Surgery, Academic Medical Center Amsterdam, The Netherlands

author email corresponding author email

Health and Quality of Life Outcomes 2007, 5:35doi:10.1186/1477-7525-5-35

Published:	2 July 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.