Christoffersen Mette W, Rosenberg Jacob, Jorgensen Lars Nannestad, Bytzer Peter, Bisgaard Thue
Department of Surgery, Køge Hospital, University Hospital of Copenhagen, Køge, Denmark,
World J Surg. 2014 Jul;38(7):1852-9. doi: 10.1007/s00268-013-2411-0.
Patient-related outcome measures (PROM) such as quality of life (QoL) after hernia repair are important to monitor, since QoL is an important indication of a hernia repair. Carolinas Comfort Scale (CCS) is a hernia-specific questionnaire regarding health-related QoL after a mesh hernia repair. The primary objective of this study was to monitor changes in health-related QoL over time after different mesh hernia repair procedures using the CCS.
We performed a prospective study with an exploratory, intraobserver design enrolling consecutive patients who were to undergo elective mesh hernia repair. Four different hernia repair techniques were included and analyzed specifically for each surgical group. Patients scored themselves using CCS preoperatively and at several fixed times postoperatively. Since no gold standard exists for either hernia-specific QoL questionnaires or change of scores on PROMs as a function of time after hernia repair, we compared the CCS scores with the visual analog scale (VAS) scores reflecting the subdomains of the CCS.
A total of 166 patients completed the study. CCS scores for QoL, pain, sensation of mesh, and activity limitations changed significantly with time during the 90-day study period. Furthermore, CCS and VAS showed significant agreement and correlation (ρ = 0.52-0.82, P < 0.001).
The present study is the first to demonstrate significant changes over time in health-related QoL using the CCS after four different types of hernia repair with mesh.
患者相关结局指标(PROM),如疝气修补术后的生活质量(QoL),对于监测很重要,因为生活质量是疝气修补术的一个重要指标。卡罗莱纳舒适度量表(CCS)是一份关于网状疝气修补术后与健康相关生活质量的特定于疝气的问卷。本研究的主要目的是使用CCS监测不同网状疝气修补术后与健康相关生活质量随时间的变化。
我们进行了一项前瞻性研究,采用探索性、观察者内设计,纳入连续接受择期网状疝气修补术的患者。纳入了四种不同的疝气修补技术,并对每个手术组进行了具体分析。患者在术前和术后几个固定时间使用CCS对自己进行评分。由于对于特定于疝气的生活质量问卷或疝气修补术后作为时间函数的PROM评分变化,不存在金标准,我们将CCS评分与反映CCS子领域的视觉模拟量表(VAS)评分进行了比较。
共有166名患者完成了研究。在90天的研究期间,生活质量、疼痛、网状物感觉和活动受限的CCS评分随时间显著变化。此外,CCS和VAS显示出显著的一致性和相关性(ρ = 0.52 - 0.82,P < 0.001)。
本研究首次证明,在使用CCS对四种不同类型的网状疝气修补术后,与健康相关的生活质量随时间有显著变化。