Zaborszky Andras, Gyanti Rita, Barry John A, Saxby Brian K, Bhattacharya Panchanan, Hasan Fazal A
Department of General Surgery, Benenden Hospital, Cranbrook, UK.
Ann R Coll Surg Engl. 2011 May;93(4):281-5. doi: 10.1308/003588411X13020150727480.
The NHS is required to collect data from patient reported outcome measures (PROMs) for inguinal hernia surgery. We explored the use of one such measure, the Carolinas Comfort Scale(®) (CCS), to compare long-term outcomes for patients who received two different types of mesh. The CCS questionnaire asks about mesh sensation, pain and movement limitations, and combines the answers into a total score.
A total of 684 patients were treated between January 2007 and August 2008 and were followed up in November 2009.
Data on 215 patients who met the inclusion criteria were available (96 patients who received Surgipro™ mesh and 119 who received Parietene™ Progrip™ mesh). Recurrence rates were similar in the Surgipro™ group (2/96, 2.1%) and Progrip™ group (3/118, 2.5%) (Fisher's exact test = 1.0). Chronic pain occurred less frequently in the Surgipro™ group (11/95, 11.6%) than in the Progrip™ group (22/118, 18.6%) (p<0.157). Overall, 90% of CCS total scores indicated a good outcome (scores of 10 or less out of 115). A principal component analysis of the CCS found that responses clustered into two subscales: 'mesh sensation' and 'pain+movement limitations'. The Progrip™ group had a slightly higher mesh sensation score (p<0.051) and similar pain+movement limitations scores (p<0.120).
In this study of quality of life outcomes related to different mesh types, the CCS subscales were more sensitive to differences in outcome than the total CCS score for the whole questionnaire. Future research should consider using the CCS subscales rather than the CCS total score.
英国国家医疗服务体系（NHS）被要求收集腹股沟疝手术患者报告结局测量（PROMs）的数据。我们探讨了使用一种这样的测量方法，即卡罗莱纳舒适度量表（®）（CCS），来比较接受两种不同类型补片的患者的长期结局。CCS问卷询问补片感觉、疼痛和活动受限情况，并将答案合并为一个总分。
2007年1月至2008年8月期间共治疗了684例患者，并于2009年11月进行随访。
有215例符合纳入标准的患者的数据可用（96例接受Surgipro™补片，119例接受Parietene™Progrip™补片）。Surgipro™组（2/96，2.1%）和Progrip™组（3/118，2.5%）的复发率相似（Fisher精确检验=1.0）。Surgipro™组慢性疼痛的发生率（11/95，11.6%）低于Progrip™组（22/118，18.6%）（p<0.157）。总体而言，90%的CCS总分表明结局良好（115分中得分为10分或更低）。对CCS进行主成分分析发现，回答聚集为两个子量表：“补片感觉”和“疼痛+活动受限”。Progrip™组的补片感觉得分略高（p<0.051），疼痛+活动受限得分相似（p<0.120）。
在这项关于不同补片类型相关生活质量结局的研究中，CCS子量表比整个问卷的CCS总分对结局差异更敏感。未来的研究应考虑使用CCS子量表而非CCS总分。
