Disability in Restorative Proctocolectomy Recipients Measured using the Inflammatory Bowel Disease Disability Index.
OBJECTIVE
The inflammatory bowel disease [IBD] disability index [IBD-DI], which measures IBD-associated disability, has been validated on IBD patients but not those who have had restorative proctocolectomy with ileal pouch-anal anastomosis [RP with IPAA]. This study aimed to utilize the IBD-DI in RP with IPAA recipients and compare ulcerative colitis [UC]-indicated RP with IPAA patients to medically treated UC patients.


METHODS
This study was population based. Demographic, indication, complication and direct cost data were collected via medical records while disability, quality of life [QoL] and indirect costs were measured using questionnaires and structured interviews. De-identified raw data about medically treated UC patients were provided by a previous study for comparison.


RESULTS
In total there were 136 RP with IPAA patients [mean 11.5 years of follow up]. Eighty-four completed the IBD-DI and 80 completed the IBD questionnaire [IBDQ]. The IBDQ and IBD-DI were highly correlated [r = 0.84, p < 0.01]. Worse QoL and disability were found in those who had their position affected at work [both p < 0.01] and those who had more than 100 days off work in the last year [p < 0.01 for QoL and p = 0.012 for disability]. Lower QoL and disability scores were associated with higher indirect and total costs [p < 0.01]. UC patients treated with RP with IPAA had less disability than medically treated UC patients [p = 0.04].


CONCLUSIONS
Disability in RP with IPAA recipients can be measured using the IBD-DI. Perioperative complications and high costs of care are associated with higher levels of disability. Disability of RP with IPAA recipients was lower than that of medically managed UC patients.
Canterbury District Health Board, New Zealand.
Y
Y
Lee
University of Otago, Christchurch, New Zealand mccombieandrew@hotmail.com.
A
A
McCombie
Canterbury District Health Board, New Zealand.|University of Otago, Christchurch, New Zealand.
R
R
Gearry
Canterbury District Health Board, New Zealand.|University of Otago, Christchurch, New Zealand.
F A
FA
Frizelle
University of Otago, Christchurch, New Zealand.
R
R
Vanamala
University of New South Wales, Sydney, Australia.
R W
RW
Leong
Canterbury District Health Board, New Zealand.|University of Otago, Christchurch, New Zealand.
T
T
Eglinton
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000191:economics / Q000601:surgery; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000191:economics; D011788:Quality of Life; D011795:Surveys and Questionnaires
Disability; inflammatory bowel disease; quality of life