Development of a pouch functional score following restorative proctocolectomy.
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.


METHODS
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 beta 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 (r(s) = -0.47, P < 0.001).


CONCLUSIONS
Stool frequency, urgency, incontinence and need for medication are major determinants of quality of life following RPC. The PFS demonstrated good correlation with CGQL.
Lovegrove
R E
RE
Department of Biosurgery and Surgical Technology, Imperial College London, London, UK.
Fazio
V W
VW
Remzi
F H
FH
Tilney
H S
HS
Nicholls
R J
RJ
Tekkis
P P
PP
D000328:Adult; D039021:Colonic Pouches / Q000502:physiology*; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016737:Proctocolectomy, Restorative / Q000706:statistics & numerical data*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards