title: A prospective longitudinal evaluation and affecting factors of health related quality of life after appendectomy.
abstract: BACKGROUND
  The aim of the present study was to longitudinally evaluate the pattern of Health-Related Quality of Life (HRQoL) alterations, as an indirect convalescence index after appendectomy, to assess the timing of its restoration to the healthy population levels and to attempt a profound investigation into factors determining HRQoL outcomes.
  
  
  METHODS
  Uncomplicated cases of histologically verified acute appendicitis (AA) were enrolled in a prospective cohort study. HRQoL indices were collected at baseline, 15 days, 1 and 3 months using EQ-5D, SF-36 and, GIQLI questionnaires. Data were processed with non-parametric tests and logistic regression analysis.
  
  
  RESULTS
  For the 147 patients eventually included, significant improvements compared to baseline at EQ-5D and SF-36 general health and physical function domains were noted at 15 days, while bodily pain was worse. The majority HRQoL parameters were significantly better at the 1st and the 3rd-month compared to baseline and the 15th-day assessments. General health, physical and emotional function were restored at the general population levels between 15 days and 1 month, while bodily pain, social function and EQ-5D indices between the 1st and 3rd month. Logistic regression analysis indicated that high Alvarado score was the most powerful predictor of HRQoL impairment with older age coming second.
  
  
  CONCLUSIONS
  Post-appendectomy HRQoL disturbances predominate and the burden of AA should not be underestimated. Convalescence period as translated by HRQoL restoration may be extended beyond the second week and up to the first month. Degree of inflammation and patient's age emerged as key mediators of HRQoL outcomes.
authors.affiliation: Department of Surgery, "Geniko Kratiko" Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Koumarelas
authors.affiliation: First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece. Electronic address: georgetheocrs@hotmail.com.
authors.forename: George E
authors.initials: GE
authors.lastname: Theodoropoulos
authors.affiliation: First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece.
authors.forename: Basileios G
authors.initials: BG
authors.lastname: Spyropoulos
authors.affiliation: First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Bramis
authors.affiliation: First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Manouras
authors.affiliation: First Department of Propaedeutic Surgery, Athens Medical School, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Zografos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001062:Appendectomy; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Acute appendicitis; Appendectomy; EQ-5D; Gastrointestinal Quality of Life Index; Health-Related Quality of Life; SF-36