This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Development of a pouch functional score following restorative proctocolectomy. BJS 2010; 97: 945-951.
Published: 20th April 2010
Authors: R. E. Lovegrove, V. W. Fazio, F. H. Remzi, H. S. Tilney, R. J. Nicholls, P. P. Tekkis et al.
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.
Method
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. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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