title: Extent of gastric resection impacts patient quality of life: the Dysfunction After Upper Gastrointestinal Surgery for Cancer (DAUGS32) scoring system.
abstract: BACKGROUND
  Quality of life is an important outcome measure in the care of patients with cancer. We developed a new scoring system specifically for the evaluation of patients with upper gastrointestinal cancer and postoperative gastrointestinal dysfunction. This study was undertaken to evaluate the scoring system's validity in comparing outcomes after gastric resection.
  
  
  METHODS
  Patients with gastric cancer, 3 months to 3 years postoperatively, were surveyed using the survey instrument. Postoperative dysfunction scores and the status of resuming activities of daily living were compared with the surgical procedure performed by analysis of variance and multiple-comparison techniques.
  
  
  RESULTS
  Of 211 patients surveyed, 165 (119 men, 46 women; mean age, 65.1 ± 10.5 years) responded. Procedures included distal gastrectomy in 100, total gastrectomy in 57, and pylorus-preserving gastrectomy in 8. The overall dysfunction score was 61.8 ± 15.5. The dysfunction score was 58.9 ± 15.0 after distal gastrectomy, 66.8 ± 14.1 after total gastrectomy, and 62.4 ± 21.6 after pylorus-preserving gastrectomy. These values differed significantly among the groups (P = .007). Dysfunction scores according to postoperative activity status were 49.1 ± 15.6 in 71 patients who resumed their activities, 56.9 ± 15.7 in 39 patients with reduced activities, 57.3 ± 8.8 in 15 patients with minimal activities, and 63.3 ± 11.8 (P < .05) in 16 patients who did not resume activities because of poor physical condition.
  
  
  CONCLUSIONS
  This scoring system for postoperative gastrointestinal dysfunction provides an objective measure of dysfunction related to specific surgical procedures and correlates with activities of daily living in the postoperative period.
authors.affiliation: Department of Nursing, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Misuzu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hosoya
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Isao
authors.initials: I
authors.lastname: Miyashiro
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kurashina
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morooka
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.forename: Alan T
authors.initials: AT
authors.lastname: Lefor
mesh_terms: D000368:Aged; D005260:Female; D005743:Gastrectomy; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome