title: Complications among colorectal cancer survivors: SF-6D preference-weighted quality of life scores.
abstract: BACKGROUND
  Societal preference-weighted health-related quality of life (HRQOL) scores enable comparing multidimensional health states across diseases and treatments for research and policy.
  
  
  OBJECTIVE
  To assess the effects of living with a permanent intestinal stoma, compared with a major bowel resection, among colorectal cancer (CRC) survivors.
  
  
  METHODS
  Cross-sectional multivariate linear regression analysis to explain preference-weighted HRQOL scores.
  
  
  METHODS
  In all, 640 CRC survivors (≥ 5 years) from 3 group model health maintenance organizations; ostomates and nonostomates with colorectal resections for CRC were matched on gender, age (± 5 years), time since diagnosis, and tumor site (rectum vs. colon).
  
  
  METHODS
  SF-6D scoring system was applied to Medical Outcomes Study Short Form-36 version 2 (SF-36v2); City of Hope Quality of Life-Ostomy; and Charlson-Deyo comorbidity index.
  
  
  METHODS
  Survey of CRC survivors linked to respondents' clinical data extracted from health maintenance organization files.
  
  
  RESULTS
  Response rate was 52%. Ostomates and nonostomates had similar sociodemographic characteristics. Mean SF-6D score was 0.69 for ostomates, compared with 0.73 for nonostomates (P < 0.001), but other factors explained this difference. Complications of initial cancer surgery, and previous year comorbidity burden, and hospital use were negatively associated with SF-6D scores, whereas household income was positively associated.
  
  
  CONCLUSIONS
  CRC survivors' SF-6D scores were not associated with living with a permanent ostomy after other factors were taken into account. Surgical complications, comorbidities, and metastatic disease lowered the preference-weighted HRQOL of CRC survivors with and without ostomies. Further research to understand and reduce late complications from CRC surgeries as well as associated depression is warranted.
authors.affiliation: The Center for Health Research, Northwest/Hawaii/Southeast, Kaiser Permanente Northwest, Portland, OR 97227, USA. c.hornbrook@kpchr.org
authors.forename: Mark C
authors.initials: MC
authors.lastname: Hornbrook
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.forename: Stephen Joel
authors.initials: SJ
authors.lastname: Coons
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Herrinton
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Carol M
authors.initials: CM
authors.lastname: Baldwin
authors.forename: Carmit K
authors.initials: CK
authors.lastname: McMullen
authors.forename: Sylvan B
authors.initials: SB
authors.lastname: Green
authors.forename: Andrea
authors.initials: A
authors.lastname: Altschuler
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rawl
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000150:complications* / Q000601:surgery; D003125:Colostomy / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D013997:Time Factors