Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Division of Urology, Department of Surgery, Cook County Health & Hospitals System, Chicago, IL.
Urology. 2022 Dec;170:60-65. doi: 10.1016/j.urology.2022.08.030. Epub 2022 Sep 1.
To assess alterations in health-related quality of life (HRQOL) in patients with nephrolithiasis, given the limited prospective data on patient reported outcomes following surgical intervention with ureteroscopy.
Adults with either a renal or ureteral calculus who underwent ureteroscopy (URS) were recruited prospectively from 2017-2020. Participants completed the PROMIS-29 profile which measures the dimensions of physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance at enrollment, 1-, 6-, and 12-months. Scores are reported as T-scores (normalized to US-population) and were compared at each time point against the mean for the US-population (50) using one-sample Welch's t'test and between each pairwise time point comparison using a Wilcoxon signed rank test.
At enrollment, a total of 69 participants completed the PROMIS-29 survey. As compared to the US-population mean, participants at enrollment had significantly different scores in physical function, fatigue, pain interference, depressive symptoms, anxiety, and sleep disturbance (all P<.05), but not ability to participate in social roles and activities. In pairwise comparisons, improvement was only observed from enrollment to 1-month in pain interference (P<.01) and fatigue (P = .03). However, there was improvement at a longer interval from enrollment to 12-months in all dimensions (pairwise comparisons, all P<.05) except depressive symptoms.
The PROMIS-29 profile is responsive to changes in HRQOL for patients with nephrolithiasis undergoing URS, with improvement of PROMIS scores up to 12-months. This information can be utilized for patient counseling to guide expectations during the recovery period.
评估接受输尿管镜检查术 (URS) 治疗的肾结石患者健康相关生活质量 (HRQOL) 的变化,因为针对手术干预后患者报告结局的前瞻性数据有限。
2017 年至 2020 年期间,前瞻性招募了接受 URS 治疗的肾或输尿管结石的成年患者。参与者在入组时、1 个月、6 个月和 12 个月时完成了 PROMIS-29 简表,该量表测量了身体功能、疲劳、疼痛干扰、抑郁症状、焦虑、参与社会角色和活动的能力以及睡眠障碍的维度。分数以 T 评分(与美国人群标准化)报告,并使用单样本 Welch's t 检验在每个时间点与美国人群平均值(50)进行比较,并使用 Wilcoxon 符号秩检验在每个两两时间点比较之间进行比较。
入组时,共有 69 名参与者完成了 PROMIS-29 调查。与美国人群平均值相比,入组时参与者在身体功能、疲劳、疼痛干扰、抑郁症状、焦虑和睡眠障碍方面的评分明显不同(均 P<.05),但在参与社会角色和活动方面的评分没有差异。在两两比较中,仅在入组后 1 个月时观察到疼痛干扰(P<.01)和疲劳(P=.03)的改善。然而,从入组到 12 个月时,所有维度都有更长时间的改善(两两比较,均 P<.05),除了抑郁症状。
PROMIS-29 简表对接受 URS 治疗的肾结石患者的 HRQOL 变化敏感,PROMIS 评分在 12 个月内有所改善。这些信息可用于患者咨询,以指导恢复期的预期。