title: Comorbidities play a larger role in predicting health-related quality of life compared to having an ostomy.
abstract: BACKGROUND
  Previous research suggests an ostomy worsens health-related quality of life (HR-QOL), but comorbidities also can affect HR-QOL.
  
  
  METHODS
  Eligible patients had abdominal operation with ostomy (cases) or similar procedure without ostomy (controls). Patients were recruited for this case-control study from 3 Veterans Affairs hospital medical and pharmacy records. Comorbidities were assessed with Charlson-Deyo Comorbidity Index. Multinomial logistic regression evaluated the impact of comorbidities and having an ostomy on HR-QOL, measured using the Medical Outcomes Study Short Form 36 for Veterans.
  
  
  RESULTS
  A total of 237 ostomates (cases) and 268 controls were studied. Average age was 69 years; 64% of cases had colostomy, 36% ileostomy. Twenty-nine percent of patients had a high level of comorbidities. Cases and controls were similar except for reasons for undergoing surgery. High comorbidity was a significant predictor of low HR-QOL in 6 domains of the Short Form 36 for Veterans; having an ostomy was a significant predictor in 4.
  
  
  CONCLUSIONS
  High comorbidity significantly influences low HR-QOL and impacted more domains than having an ostomy.
authors.affiliation: Center for Surgical Outcomes and Quality, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA. sjain@mednet.ucla.edu
authors.forename: Sushma
authors.initials: S
authors.lastname: Jain
authors.forename: Marcia L
authors.initials: ML
authors.lastname: McGory
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
authors.forename: Alla
authors.initials: A
authors.lastname: Sverdlik
authors.forename: James S
authors.initials: JS
authors.lastname: Tomlinson
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.forename: Stephen Joel
authors.initials: SJ
authors.lastname: Coons
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rawl
authors.forename: C Max
authors.initials: CM
authors.lastname: Schmidt
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Carol M
authors.initials: CM
authors.lastname: Baldwin
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003125:Colostomy; D015897:Comorbidity; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007081:Ileostomy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010030:Ostomy; D011788:Quality of Life; D012959:Socioeconomic Factors