Abdalla Maisa I, Sandler Robert S, Kappelman Michael D, Martin Christopher F, Chen Wenli, Anton Kristen, Long Millie D
*Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and †Department of Pediatrics, Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Inflamm Bowel Dis. 2016 Nov;22(11):2658-2664. doi: 10.1097/MIB.0000000000000930.
The potential need for an ostomy is a main concern for patients with inflammatory bowel disease. We performed this study to evaluate the impact of a long-term ostomy (≥6 mo duration) on the functional status and specific patient-reported outcomes in a population of patients with Crohn's disease (CD).
We performed a cross-sectional analysis within the Crohn's and Colitis Foundation of America Partners cohort. Bivariate analyses and logistic regression models were used to investigate associations between ostomy and various demographic, disease factors, and patient-reported outcomes for health-related quality of life.
A total of 402 CD patients with ostomy for a minimum duration of 6 months were compared with 4331 CD patients with no ostomy. Patients with ostomy were more likely to be in clinical remission compared with those without ostomy, 48.5% versus 31.3%, respectively. Having an ostomy did not impact the overall health-related quality of life and was not associated with anxiety, depression, sleep disturbances, or reduced sexual interest and satisfaction. However, the presence of ostomy was associated with reduced social role satisfaction in both patients with controlled and active disease. Additionally, in the subset of patients who did not achieve clinical remission, those with ostomy experienced greater pain interference (odds ratio, 1.63; 95% confidence interval, 1.12-2.35) and fatigue (odds ratio, 1.66; 95% confidence interval, 1.15-2.39).
Ostomy is well tolerated in CD patients, particularly when clinical remission is achieved.
对于炎症性肠病患者而言,造口术的潜在需求是一个主要担忧。我们开展这项研究以评估长期造口术(持续时间≥6个月)对克罗恩病(CD)患者功能状态及特定患者报告结局的影响。
我们在美国克罗恩病和结肠炎基金会合作伙伴队列中进行了横断面分析。采用双变量分析和逻辑回归模型来研究造口术与各种人口统计学、疾病因素以及患者报告的健康相关生活质量结局之间的关联。
共将402例造口持续时间至少6个月的CD患者与4331例未行造口术的CD患者进行了比较。与未行造口术的患者相比,行造口术的患者更有可能处于临床缓解期,分别为48.5%和31.3%。造口术并未影响整体健康相关生活质量,也与焦虑、抑郁、睡眠障碍或性兴趣及满意度降低无关。然而,无论疾病处于缓解期还是活动期,造口的存在均与社会角色满意度降低有关。此外,在未实现临床缓解的患者亚组中,行造口术的患者经历了更大的疼痛干扰(比值比,1.63;95%置信区间,1.12 - 2.35)和疲劳(比值比,1.66;95%置信区间,1.15 - 2.39)。
CD患者对造口术耐受性良好,尤其是在实现临床缓解时。