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Development of a pouch functional score following restorative proctocolectomy

✍ Scribed by R. E. Lovegrove; V. W. Fazio; F. H. Remzi; H. S. Tilney; R. J. Nicholls; Mr P. P. Tekkis

Publisher: John Wiley and Sons
Year: 2010
Tongue: English
Weight: 174 KB
Volume: 97
Category: Article
ISSN: 0007-1323
DOI: 10.1002/bjs.7021

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

Background

The influence of function on quality of life after primary restorative proctocolectomy (RPC) was determined with the aim of developing a pouch functional score.

Methods

The Cleveland Global Quality of Life (CGQL) score was determined in 4013 patients undergoing RPC between 1977 and 2005 (mean(s.d.) follow-up 7·0(5·1) years; 13 105 follow-up episodes). Linear regression analysis was used to identify independent symptom domains of function as possible predictors of quality of life to develop and validate a pouch functional score.

Results

CGQL scores at 1, 5, 10, 15 and 20 years were 85·0, 87·5, 87·5, 85·0 and 82·5 respectively (P = 0·001). On multivariable analysis, the symptom domains of stool frequency (24 h, nocturnal), urgency, incontinence and medication (antidiarrhoeals, antibiotics) were independently associated with CGQL (P < 0·001). The β coefficients within each symptom domain were then adjusted to create a scale of 0–30 for practical use, the Pouch Functional Score (PFS), which correlated with the CGQL score (rs = −0·47, P < 0·001).

Conclusion

Stool frequency, urgency, incontinence and need for medication are major determinants of quality of life following RPC. The PFS demonstrated good correlation with CGQL.

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