Psychosocial Factors Are Associated with Quality of Life after Laparoscopic Antireflux Surgery

Alexa K. Statz, Andrea Stroud, Sally A. Jolles, Jacob A. Greenberg, Anne O. Lidor, Amber L. Shada, Xing Wang, Luke M. Funk

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. Methods: Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015. Electronic health record data were reviewed to extract patient characteristics, diagnostic study characteristics, and operative data. Postoperative GERD-HRQL data were obtained through telephone follow-up. Variables hypothesized a priori to be associated with high GERD-HRQL after LARS, which were significant at P ≤ .2 on bivariate analysis, were entered into a multivariable linear regression model with GERD-HRQL as the outcome. Results: The study included 248 patients; 69.0% were female, 56.9% were married, and 58.1% had concurrent atypical symptoms. The most commonly performed fundoplications were Nissen (44.8%), Toupet (41.3%), and Dor (14.1%), respectively. The median follow-up interval was 3.4 years. The telephone response rate was 60.1%. GERD-HRQL scores improved from 24.8 (SD ±11.4) preoperatively to 3.0 (SD ±5.9) postoperatively. 79.9% of patients were satisfied with their condition at follow-up. On multivariable analysis, being married (P = .04) and absence of depression (P = .02) were independently associated with a higher postoperative QoL. Conclusions: Strong social support and psychiatric well-being appear to be important predictors of a higher QoL following LARS. Optimizing social support and treating depression preoperatively and postoperatively may improve QoL outcomes for LARS patients.

Original languageEnglish (US)
Pages (from-to)755-760
Number of pages6
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume27
Issue number8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Gastroesophageal Reflux
Laparoscopy
Quality of Life
Psychology
Telephone
Social Support
Linear Models
Community Psychiatry
Fundoplication
Electronic Health Records
Databases

Keywords

  • Gastroesophageal reflux disease
  • Health-related quality of life
  • Laparoscopic antireflux surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Psychosocial Factors Are Associated with Quality of Life after Laparoscopic Antireflux Surgery. / Statz, Alexa K.; Stroud, Andrea; Jolles, Sally A.; Greenberg, Jacob A.; Lidor, Anne O.; Shada, Amber L.; Wang, Xing; Funk, Luke M.

In: Journal of Laparoendoscopic and Advanced Surgical Techniques, Vol. 27, No. 8, 01.08.2017, p. 755-760.

Research output: Contribution to journalArticle

Statz, Alexa K. ; Stroud, Andrea ; Jolles, Sally A. ; Greenberg, Jacob A. ; Lidor, Anne O. ; Shada, Amber L. ; Wang, Xing ; Funk, Luke M. / Psychosocial Factors Are Associated with Quality of Life after Laparoscopic Antireflux Surgery. In: Journal of Laparoendoscopic and Advanced Surgical Techniques. 2017 ; Vol. 27, No. 8. pp. 755-760.
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abstract = "Background: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. Methods: Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015. Electronic health record data were reviewed to extract patient characteristics, diagnostic study characteristics, and operative data. Postoperative GERD-HRQL data were obtained through telephone follow-up. Variables hypothesized a priori to be associated with high GERD-HRQL after LARS, which were significant at P ≤ .2 on bivariate analysis, were entered into a multivariable linear regression model with GERD-HRQL as the outcome. Results: The study included 248 patients; 69.0{\%} were female, 56.9{\%} were married, and 58.1{\%} had concurrent atypical symptoms. The most commonly performed fundoplications were Nissen (44.8{\%}), Toupet (41.3{\%}), and Dor (14.1{\%}), respectively. The median follow-up interval was 3.4 years. The telephone response rate was 60.1{\%}. GERD-HRQL scores improved from 24.8 (SD ±11.4) preoperatively to 3.0 (SD ±5.9) postoperatively. 79.9{\%} of patients were satisfied with their condition at follow-up. On multivariable analysis, being married (P = .04) and absence of depression (P = .02) were independently associated with a higher postoperative QoL. Conclusions: Strong social support and psychiatric well-being appear to be important predictors of a higher QoL following LARS. Optimizing social support and treating depression preoperatively and postoperatively may improve QoL outcomes for LARS patients.",
keywords = "Gastroesophageal reflux disease, Health-related quality of life, Laparoscopic antireflux surgery",
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AU - Statz, Alexa K.

AU - Stroud, Andrea

AU - Jolles, Sally A.

AU - Greenberg, Jacob A.

AU - Lidor, Anne O.

AU - Shada, Amber L.

AU - Wang, Xing

AU - Funk, Luke M.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. Methods: Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015. Electronic health record data were reviewed to extract patient characteristics, diagnostic study characteristics, and operative data. Postoperative GERD-HRQL data were obtained through telephone follow-up. Variables hypothesized a priori to be associated with high GERD-HRQL after LARS, which were significant at P ≤ .2 on bivariate analysis, were entered into a multivariable linear regression model with GERD-HRQL as the outcome. Results: The study included 248 patients; 69.0% were female, 56.9% were married, and 58.1% had concurrent atypical symptoms. The most commonly performed fundoplications were Nissen (44.8%), Toupet (41.3%), and Dor (14.1%), respectively. The median follow-up interval was 3.4 years. The telephone response rate was 60.1%. GERD-HRQL scores improved from 24.8 (SD ±11.4) preoperatively to 3.0 (SD ±5.9) postoperatively. 79.9% of patients were satisfied with their condition at follow-up. On multivariable analysis, being married (P = .04) and absence of depression (P = .02) were independently associated with a higher postoperative QoL. Conclusions: Strong social support and psychiatric well-being appear to be important predictors of a higher QoL following LARS. Optimizing social support and treating depression preoperatively and postoperatively may improve QoL outcomes for LARS patients.

AB - Background: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS. Methods: Clinical data from our single institution foregut surgery database were used to identify all patients with GERD who underwent primary LARS from June 2010 to November 2015. Electronic health record data were reviewed to extract patient characteristics, diagnostic study characteristics, and operative data. Postoperative GERD-HRQL data were obtained through telephone follow-up. Variables hypothesized a priori to be associated with high GERD-HRQL after LARS, which were significant at P ≤ .2 on bivariate analysis, were entered into a multivariable linear regression model with GERD-HRQL as the outcome. Results: The study included 248 patients; 69.0% were female, 56.9% were married, and 58.1% had concurrent atypical symptoms. The most commonly performed fundoplications were Nissen (44.8%), Toupet (41.3%), and Dor (14.1%), respectively. The median follow-up interval was 3.4 years. The telephone response rate was 60.1%. GERD-HRQL scores improved from 24.8 (SD ±11.4) preoperatively to 3.0 (SD ±5.9) postoperatively. 79.9% of patients were satisfied with their condition at follow-up. On multivariable analysis, being married (P = .04) and absence of depression (P = .02) were independently associated with a higher postoperative QoL. Conclusions: Strong social support and psychiatric well-being appear to be important predictors of a higher QoL following LARS. Optimizing social support and treating depression preoperatively and postoperatively may improve QoL outcomes for LARS patients.

KW - Gastroesophageal reflux disease

KW - Health-related quality of life

KW - Laparoscopic antireflux surgery

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