Taryn E Hassinger, MD, MS, George Stukenborg, PhD, Charles M Friel, MD, Traci L Hedrick, MD, MS. University Of Virginia
|PROMIS Domain||Coefficient||95% CI||p value|
|Depression||-2.14||(-10.76 – 6.49)||0.62|
|Interest in sex||1.82||(-12.77 – 16.41)||0.80|
|Pain interference||-0.78||(-9.14 – 7.57)||0.85|
|Ability to participate||2.78||(-6.83 – 12.38)||0.57|
Introduction: The use of minimally-invasive techniques in colorectal surgery has gained popularity due to benefits in both short-term and long-term clinical outcomes. Patient-reported outcomes (PRO) are increasingly recognized as vital measures of clinical outcomes and performance. This study aims to compare physical, mental, and social PRO in patients undergoing open and laparoscopic colorectal surgery with the hypothesis that patients undergoing laparoscopic surgery will report higher PROs.
Methods: This pilot study utilized the National Institutes of Health Patient-Reported Outcomes Measure Information System (PROMIS) to collect responses from patients undergoing open and laparoscopic colorectal surgery at a single institution from July 2013 to April 2015. Domains included pain interference, ability to participate in social roles and activities, depression, and interest in sexual activity. Scores were collected at 1-month preoperative and postoperative appointments. Data was reviewed using a multivariable linear model controlling for patient and procedural characteristics to determine associations between mean change in PROMIS scores and laparoscopic surgery.
Results : Surveys were completed by 107 patients, with 57 (53.3%) undergoing laparoscopic surgery. Open surgery was more common in men [31 (62.0%) vs. 17 (29.8%); p=0.008]. Colon cancer was the most common diagnosis overall, but the rate of rectal cancer was higher in the open surgery group [18 (36.0%) vs. 9 (15.8%)], as were rates of neoadjuvant chemotherapy (p=0.02) and radiation (p=0.004). Preoperative (p=0.01) and postoperative (p<0.0001) stomas were less common in the laparoscopic group. There were no unadjusted differences in mean PROMIS score changes among patients undergoing open and laparoscopic surgery across included domains. Likewise, the multivariable analysis identified no association between the mean changes in PROMIS scores and laparoscopic surgery in any of the assessed domains (Table).
Conclusions: This pilot study demonstrated that PROMIS can be used to collect PROs in a busy colorectal surgery clinic. These data do not demonstrate a difference in PROs between laparoscopic and open colorectal surgery patients, but larger prospective studies are needed.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85410
Program Number: P193
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster