Long-term outcomes of laparoscopic cholecystectomy: a prospective piecewise linear regression analysis.
BACKGROUND
The objectives of this study were to examine longitudinal time trends, to predict thresholds of improvement in each dimension of health-related quality of life (HRQoL), and to identify long-term predictors of HRQoL.


METHODS
This study analyzed 353 laparoscopic cholecystectomy (LC) patients. Disease-specific Gastrointestinal Quality-of-Life Index (GIQLI) and generic Short-Form 36-Item Health Survey (SF-36) scores were obtained immediately before surgery, then 3, 6, 12, and 24 months after surgery. Generalized estimating equations and piecewise linear regression models were used.


RESULTS
The examined population significantly (p<0.05) improved in both SF-36 and GIQLI subscale scores. The HRQoL dimensions were substantially improved the sixth month after surgery and continued improving until they reached a plateau at 54.93 to 73.18 months. The data also showed the following explanatory variables for HRQoL: time, age, gender, Charlson Comorbidity Index, and preoperative GIQLI and SF-36 subscale scores.


CONCLUSIONS
As shown by the findings, the HRQoL scores improved substantially by the sixth month after surgery and continued improving until they reached a 4- to 7-year threshold, indicating that change trends in HRQoL dimensions may vary. Although HRQoL scores were substantially improved after cholecystectomy, the improvements were associated with preoperative functional status and demographic characteristics.
Graduate Institute of Healthcare Administration, Kaohsiung Medical University, and Department of Surgery, Kaohsiung Medical University Hospital, 100-Shih-Chun 1st Road, Kaohsiung, Taiwan. hshi@kmu.edu.tw
Hon-Yi
HY
Shi
Hao-Hsien
HH
Lee
Meng-Han
MH
Tsai
Chong-Chi
CC
Chiu
Yih-Huei
YH
Uen
King-Teh
KT
Lee
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D017081:Cholecystectomy, Laparoscopic; D015897:Comorbidity; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome