title: Staged abdominal repairs reduce long-term quality of life.
abstract: BACKGROUND
  Damage control surgery increasingly requires serial operations and a staged abdominal repair (STAR) for ultimate abdominal closure. The effects of multiple operations on quality of life are unknown. We hypothesized that this population of patients had a lower quality of life than the general U.S. population.
  
  
  METHODS
  Patients requiring STAR for general surgical and trauma diagnoses during a 5-year period from January 2002 to December 2006 were identified from the operative database of a single institution. Demographic, illness, and injury information were obtained from record review. Survivors were 3-7 years from their hospitalization for STAR when they were contacted and the SF-12v2 was administered by phone. The physical (PCS) and mental component (MCS) scores were calculated and compared to US population norms and a population of trauma patients. The non-STAR trauma population completed the SF-12v2 six months after injury.
  
  
  RESULTS
  A total of 27 patients with a mean age of 46.5 years (SD = 15.9) participated in the survey. The participants were interviewed a median of 4.7 years after injury. The mechanism of injury included 8 (29.6%) general surgical causes including 4 perforated viscus, 3 intra-abdominal infections, and 1 wound dehiscence from a urological procedure. The remaining 19 (70.4%) were trauma-related, including 13 blunt and 6 penetrating injuries. Patients who had undergone a STAR procedure reported lower levels of physical quality of life [z = -15.42, p<0.001] and mental quality of life [z = -6.79, p<0.001] compared to population norms for healthy adults. Also, STAR patients reported lower physical [z = -2.22, p<0.05] and mental [z = -2.59, p<0.05] quality of life as the non-STAR trauma group.
  
  
  CONCLUSIONS
  The number of patients undergoing STAR for a variety of reasons is increasing. Measurements of quality of life of STAR patients show that quality of life is reduced compared to a healthy U.S. adult population and to non-STAR trauma patients.
  
  
  CONCLUSIONS
  The significant impact of severe abdominal injuries continues to affect the physical and mental health of patients years later. Injuries of this type are associated with lower quality of life than those observed in patients experiencing non-STAR trauma.
authors.affiliation: Department of Surgery, Division of Trauma/Critical Care, 9200 West Wisconsin Ave, Milwaukee, WI 53226, United States. pcodner@mcw.edu
authors.forename: Panna A
authors.initials: PA
authors.lastname: Codner
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Brasel
authors.forename: Terri A
authors.initials: TA
authors.lastname: Deroon-Cassini
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D000328:Adult; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007813:Laparotomy / Q000523:psychology* / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology