title: Determinants of quality of life in children with colorectal diseases.
abstract: BACKGROUND
  Health related Quality of Life (HRQoL) is an important outcome in medical care. The aim of our study was to identify characteristics associated with lower HRQoL scores in children with anorectal malformation (ARM) and Hirschsprung disease (HD).
  
  
  METHODS
  Patients younger than 18years, with HD or ARM, who were evaluated at our center from April 2014 to August 2015, were identified. The results of comprehensive questionnaires regarding diagnosis, symptoms, comorbidities and previous medical/surgical history, and validated tools to assess urinary status, stooling status and HRQoL were evaluated.
  
  
  RESULTS
  In children aged 0-4years, vomiting and abdominal distension were found to be associated with a significant reduction in total HRQoL scores. In children >4years of age, vomiting, nausea, abdominal distension, and abdominal pain were also associated with a significantly lower HRQoL. The strongest predictor of lower HRQoL scores on regression tree analysis, in all age groups, was the presence of a psychological, behavioral or developmental comorbidity.
  
  
  CONCLUSIONS
  Patients with either HD or an ARM who have a psychological, behavioral or developmental problem experience significantly lower HRQoL than children without such problems, suggesting that provision of behavioral/developmental support as part of the multidisciplinary care of these children may have a substantial impact on their HRQoL.
authors: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, OH, USA; Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors: Victoria A
authors: VA
authors: Lane
authors: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors: Kristine M
authors: KM
authors: Nacion
authors: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
authors: Jennifer N
authors: JN
authors: Cooper
authors: Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors: Marc A
authors: MA
authors: Levitt
authors: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
authors: Katherine J
authors: KJ
authors: Deans
authors: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: peter.minneci@nationwidechildrens.org.
authors: Peter C
authors: PC
authors: Minneci
mesh_terms: D000293:Adolescent; D000071056:Anorectal Malformations / Q000503:physiopathology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003672:Defecation / Q000502:physiology*; D005260:Female; D006304:Health Status; D006627:Hirschsprung Disease / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Anorectal malformation; Hirschsprung disease; Quality of life