Predictors of quality-of-life after ileal pouch-anal anastomosis in patients with ulcerative colitis

Scand J Gastroenterol. 2017 Oct;52(10):1078-1085. doi: 10.1080/00365521.2017.1337218. Epub 2017 Jun 9.

Abstract

Objectives: Predictors of the postoperative quality of life (QoL) following ileal pouch anal anastomosis (IPAA) have not been thoroughly investigated. This study was planned to assess the postoperative QoL following IPAA and to identify its predictors using the 15D instrument.

Materials and methods: A retrospective cohort study was conducted on IPAA-operated patients with ulcerative colitis in two Finnish tertiary hospitals during the period 1985-2014 (n = 485). Medical records were examined to collect data on baseline, operative and postoperative characteristics. Patients were surveyed using the 15D-instrument to assess their postoperative QoL. Linear regression analyses and receiver operating characteristic curve were applied to identify the predictors of postoperative QoL.

Results and conclusions: Of all patients, 61.5% experienced worse postoperative QoL, with significantly lower QoL level than that of an age and sex-standardized general population in 12 dimensions of the 15D-instrument, with the highest mean difference QoL scores calculated for excretion, sexual activity and sleeping dimensions. Older age and preoperative hypertension were the only significant predictors of lower overall QoL (p = .003 and p = .03, respectively). A preoperative age of ≥35 years was the most valid predictor of lower postoperative QoL (Sensitivity = 62.4% and Specificity = 49.6%, p = .04). In conclusion, postoperative QoL is generally low using the 15D-instrument after IPAA. Worse postoperative QoL is predicted after the age of 35.

Keywords: 15D-instrument; IPAA; Ileal pouch-anal anastomosis; QoL; quality-of-life; ulcerative colitis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / physiopathology
  • Colitis, Ulcerative / surgery*
  • Female
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Postoperative Period
  • Preoperative Period
  • Proctocolectomy, Restorative* / adverse effects
  • Proctocolectomy, Restorative* / psychology
  • Quality of Life* / psychology
  • ROC Curve
  • Retrospective Studies