Staged abdominal repairs reduce long-term quality of life

Panna A. Codner, Karen Brasel, Terri A. Deroon-Cassini

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Introduction: Damage control surgery increasingly requires serial operations and a staged abdominal repair (STAR) for ultimate abdominal closure. The effects of multiple operations on quality of life are unknown. We hypothesized that this population of patients had a lower quality of life than the general U.S. population. Methods: Patients requiring STAR for general surgical and trauma diagnoses during a 5-year period from January 2002 to December 2006 were identified from the operative database of a single institution. Demographic, illness, and injury information were obtained from record review. Survivors were 3-7 years from their hospitalization for STAR when they were contacted and the SF-12v2 was administered by phone. The physical (PCS) and mental component (MCS) scores were calculated and compared to US population norms and a population of trauma patients. The non-STAR trauma population completed the SF-12v2 six months after injury. Results: A total of 27 patients with a mean age of 46.5 years (SD = 15.9) participated in the survey. The participants were interviewed a median of 4.7 years after injury. The mechanism of injury included 8 (29.6%) general surgical causes including 4 perforated viscus, 3 intra-abdominal infections, and 1 wound dehiscence from a urological procedure. The remaining 19 (70.4%) were trauma-related, including 13 blunt and 6 penetrating injuries. Patients who had undergone a STAR procedure reported lower levels of physical quality of life [z = -15.42, p <0.001] and mental quality of life [z = -6.79, p <0.001] compared to population norms for healthy adults. Also, STAR patients reported lower physical [z = -2.22, p <0.05] and mental [z = -2.59, p <0.05] quality of life as the non-STAR trauma group. Discussion: The number of patients undergoing STAR for a variety of reasons is increasing. Measurements of quality of life of STAR patients show that quality of life is reduced compared to a healthy U.S. adult population and to non-STAR trauma patients. Conclusions: The significant impact of severe abdominal injuries continues to affect the physical and mental health of patients years later. Injuries of this type are associated with lower quality of life than those observed in patients experiencing non-STAR trauma.

Original languageEnglish (US)
Pages (from-to)1513-1516
Number of pages4
JournalInjury
Volume43
Issue number9
DOIs
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Quality of Life
Wounds and Injuries
Population
Intraabdominal Infections
Abdominal Injuries
Viscera
Mentally Ill Persons
Survivors
Mental Health
Hospitalization
Demography
Databases

Keywords

  • Open abdomen
  • Quality of life
  • Staged abdominal repair

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

Staged abdominal repairs reduce long-term quality of life. / Codner, Panna A.; Brasel, Karen; Deroon-Cassini, Terri A.

In: Injury, Vol. 43, No. 9, 09.2012, p. 1513-1516.

Research output: Contribution to journalArticle

Codner, Panna A. ; Brasel, Karen ; Deroon-Cassini, Terri A. / Staged abdominal repairs reduce long-term quality of life. In: Injury. 2012 ; Vol. 43, No. 9. pp. 1513-1516.
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abstract = "Introduction: Damage control surgery increasingly requires serial operations and a staged abdominal repair (STAR) for ultimate abdominal closure. The effects of multiple operations on quality of life are unknown. We hypothesized that this population of patients had a lower quality of life than the general U.S. population. Methods: Patients requiring STAR for general surgical and trauma diagnoses during a 5-year period from January 2002 to December 2006 were identified from the operative database of a single institution. Demographic, illness, and injury information were obtained from record review. Survivors were 3-7 years from their hospitalization for STAR when they were contacted and the SF-12v2 was administered by phone. The physical (PCS) and mental component (MCS) scores were calculated and compared to US population norms and a population of trauma patients. The non-STAR trauma population completed the SF-12v2 six months after injury. Results: A total of 27 patients with a mean age of 46.5 years (SD = 15.9) participated in the survey. The participants were interviewed a median of 4.7 years after injury. The mechanism of injury included 8 (29.6{\%}) general surgical causes including 4 perforated viscus, 3 intra-abdominal infections, and 1 wound dehiscence from a urological procedure. The remaining 19 (70.4{\%}) were trauma-related, including 13 blunt and 6 penetrating injuries. Patients who had undergone a STAR procedure reported lower levels of physical quality of life [z = -15.42, p <0.001] and mental quality of life [z = -6.79, p <0.001] compared to population norms for healthy adults. Also, STAR patients reported lower physical [z = -2.22, p <0.05] and mental [z = -2.59, p <0.05] quality of life as the non-STAR trauma group. Discussion: The number of patients undergoing STAR for a variety of reasons is increasing. Measurements of quality of life of STAR patients show that quality of life is reduced compared to a healthy U.S. adult population and to non-STAR trauma patients. Conclusions: The significant impact of severe abdominal injuries continues to affect the physical and mental health of patients years later. Injuries of this type are associated with lower quality of life than those observed in patients experiencing non-STAR trauma.",
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