Background:
Success of a surgical intervention is often measured by hard clinical outcomes. in ventral hernia repair (vhr) these include wound morbidity and hernia recurrence. these outcomes fail to account for a surgical intervention's effect on a patient's quality of life (qofl). our objective was to design a hernia-specific qofl instrument with a focus on abdominal wall function, evaluate its measurement properties, and assess the impact of vhr on qofl using this new instrument.
Study design:
A 16-question qofl survey tool, herqles, was constructed. patients presenting for elective vhr completed the survey. rasch modeling was used to evaluate the items; fit statistics, person-item mapping, separation index, and reliability were examined. associations between baseline characteristics and qofl were assessed.
Results:
Eighty-eight patients completed the survey before assessment for vhr. mean age was 57.2 years (ยฑ12.4 years), mean american society of anesthesiologists score was 2.8 (ยฑ0.5), and mean body mass index was 34.9 kg/m(2) (ยฑ9.3 kg/m(2)). based on rasch modeling, 12 of 16 items met model fit criteria. the 4 poorly fitting items were eliminated from further analysis. the 12 items retained have good internal consistency reliability (0.86). on a 0- to 100-point scale, mean qofl score was 47.2 (ยฑ15.6). patients with higher grade hernias had lower herqles scores (p = 0.06). patients showed significant improvement in abdominal wall function and qofl 6 months after vhr (p < 0.01).
Conclusions:
Quality-of-life is an important component of surgical management of ventral hernias. the 12-question qofl survey, herqles, is reliable and valid. at baseline, patients with more complex hernias tended to have a decreased abdominal wall function and qofl. six months after surgical repair, herqles scores change in the predicted direction. we believe herqles is potentially a valuable tool to assess patient-centered abdominal wall functional improvements after vhr.