Department of Urology, Westmead Hospital, Sydney, Australia ; University of Western Sydney, Sydney, Australia.
Department of Urology, Sydney Adventist Hospital, Sydney, Australia ; University of Sydney, Sydney, Australia.
Prostate Int. 2014 Dec;2(4):182-7. doi: 10.12954/PI.14066. Epub 2014 Dec 30.
Several international committees involved in establishing standards of care have recommended that patients undergoing surgery for bladder outlet obstruction should be assessed with patient reported outcomes (PRO). The Patient Global Impression of Improvement (PGI-I) is an instrument designed to measure a patients interpretation of symptom changes following intervention. The objective of this study was to validate the PGI-I as a PRO assessment following surgery for bladder outflow obstruction (BOO) in men with benign prostatic hyperplasia (BPH).
Men undergoing photoselective vaporisation of the prostate were followed prospectively. Pre- and postoperative International Prostate Symptom Score (IPSS), Quality of life (QoL) index, peak urinary flow (Qmax), and postvoid residual (PVR) assessments were done. The PGI-I was conducted and correlated at 3 months postoperatively to changes in IPSS, QoL, Qmax, and PVR.
One hundred and sixty-six consecutive patients were included. Following surgery, IPSS and QoL improved by 11 and 2.4 points (P<0.0001). PGI-I was found to correlate with postoperative changes in IPSS and QoL (Pearson correlation, 0.47 and 0.58, respectively; P<0.0001).
This is the first study to validate the PGI-I as a PRO measure to surgery for BOO. This suggests a potential for the PGI-I to be used to assess surgical therapies for BPH and may be a valuable addition for measuring outcomes in clinical trials evaluating surgical interventions for BPH.
参与制定护理标准的几个国际委员会建议,接受膀胱出口梗阻手术的患者应进行患者报告的结局(PRO)评估。患者总体印象改善(PGI-I)是一种旨在衡量患者在干预后对症状变化的解释的工具。本研究的目的是验证 PGI-I 作为良性前列腺增生(BPH)男性膀胱流出道梗阻(BOO)手术后的 PRO 评估。
前瞻性随访接受前列腺光选择性汽化术的男性。术前和术后进行国际前列腺症状评分(IPSS)、生活质量(QoL)指数、最大尿流率(Qmax)和残余尿量(PVR)评估。在术后 3 个月进行 PGI-I,并与 IPSS、QoL、Qmax 和 PVR 的变化相关联。
共纳入 166 例连续患者。手术后,IPSS 和 QoL 分别改善了 11 分和 2.4 分(P<0.0001)。发现 PGI-I 与术后 IPSS 和 QoL 的变化相关(Pearson 相关系数分别为 0.47 和 0.58;P<0.0001)。
这是第一项验证 PGI-I 作为 BOO 手术 PRO 测量的研究。这表明 PGI-I 有可能用于评估 BPH 的手术治疗,并且可能是评估 BPH 手术干预临床试验中衡量结果的有价值的补充。