title: Short-term patient-reported quality of life after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation.
abstract: OBJECTIVE
  To determine the short-term health status of patients after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation (CARE). Radical cystectomy and urinary diversion in patients with invasive bladder cancer can have a significant effect on patients' quality of life.
  
  
  METHODS
  A total of 91 patients completed the CARE preoperatively and postoperatively. The CARE scores were calculated from postoperative day 7 to 90. Outcome measures were calculated using the CARE difference index (CDI), defined as the difference between the baseline CARE and postoperative day 7 CARE scores. The primary outcome was the time taken to recover 90% of the CDI.
  
  
  RESULTS
  The mean age at robot-assisted radical cystectomy was 69 years (range 42-86). Of the 91 patients, 68 (74%) were men, 38 underwent extracorporeal urinary diversion, 52 underwent intracorporeal urinary diversion, and 1 underwent no diversion. A comparison of the preoperative and postoperative day 7 scores demonstrated a 48% decline in the total CARE score. The decline in specific CARE domains was 14%, 34%, 56%, and 66% against baseline for the cognition, pain, gastrointestinal, and activity domains, respectively. The mean time to recover 90% of the CDI for the total CARE score was 63 days. The mean time to recover 90% of the CDI for the pain, cognition, and activity domains was 33, 57, and 82 days, respectively. Patients did not recover 90% of the CDI for the gastrointestinal domain within the 90-day follow-up period.
  
  
  CONCLUSIONS
  Patients who underwent robot-assisted radical cystectomy approached preoperative baseline levels within 90 days using the CARE in the total CARE, pain, cognition, and activity domains but not in the gastrointestinal domain.
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stegemann
authors.forename: Shabnam
authors.initials: S
authors.lastname: Rehman
authors.forename: Katie
authors.initials: K
authors.lastname: Brewer
authors.forename: Tushar
authors.initials: T
authors.lastname: Kesavadas
authors.forename: Abid
authors.initials: A
authors.lastname: Hussain
authors.forename: Rameela
authors.initials: R
authors.lastname: Chandrasekhar
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.forename: Khurshid A
authors.initials: KA
authors.lastname: Guru
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003289:Convalescence; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012371:Robotics; D014547:Urinary Diversion