Health-related quality of life after ileocolonic resection for Crohn's disease: long-term results.
BACKGROUND
Crohn's disease (CD) is a chronic illness that interferes with the daily life of those affected. The aim of the present study was to evaluate long-term health-related quality of life (HRQL) outcome and its clinical predictors in CD patients who have had ileocolonic resection.


METHODS
Ninety-seven CD patients, with a mean follow-up of 47.1 months (95% CI, 40.7-53.5 months) after ileocolonic resection, were interviewed by telephone and responded to the generic Cleveland Global Quality of Life (CGQL) questionnaire, and 63 of them also agreed to come to our outpatient clinic to have a Crohn's Disease Activity Index (CDAI) assessment and blood test and to answer the disease-specific Padova Inflammatory Bowel Diseases Quality of Life (PIBDQL) questionnaire. Control groups also were enrolled.


RESULTS
The CGQL scores of the 97 CD patients were similar to those of 69 healthy controls. Only the item on current quality of health was scored significantly lower by patients with CD. In contrast, the PIBDQL item and total scores of the CD patients were all significantly lower than those of the respective healthy controls (P < 0.05). Multivariate analysis showed that the CGQL and PIBDQL scores both had a strong linear relationship with number of daily stools and with CDAI score (P < 0.05).


CONCLUSIONS
Despite CD patients who have undergone ileocolonic resection having an apparently normal quality of life with a good energy level, as shown by the CGQL, their long-term HRQL is still affected by a significantly impaired quality of health. In fact, the PIBDQL questionnaire showed significant impairment of bowel and systemic symptom domains with important consequences for emotional and social functions. HRQL seems to be significantly related only to current disease activity.
Scarpa
Marco
M
Department of Surgical and Gastroenterological Science, Sezione di Clinica Chirurgica I, University of Padova, Padova, Italy. marcoscarpa73@yahoo.it
Ruffolo
Cesare
C
D'Incà
Renata
R
Filosa
Teresa
T
Bertin
Eugenia
E
Ferraro
Stefania
S
Polese
Lino
L
Martin
Alessandro
A
Sturniolo
Giacomo C
GC
Frego
Mauro
M
D'Amico
Davide F
DF
Angriman
Imerio
I
D000328:Adult; D000704:Analysis of Variance; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D003106:Colon / Q000601:surgery*; D003424:Crohn Disease / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007082:Ileum / Q000601:surgery*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life