Pre-Operative Quality of Life May Predict Post-Operative Complications

Dr. Juliane Bingener-Casey, M.D. Mayo Clinic in Rochester, Interview with:
Dr. Juliane Bingener-Casey, M.D.
Mayo Clinic in Rochester, Minn

Medical Research: What are the main findings of the study?

Dr. Bingener:
Other investigators have shown that preoperative quality of life is a predictor for postoperative survival in colon and pancreas cancer surgery. In this study we looked as preoperative quality of life as a predictor for postoperative complications. The main findings of the study were that patients who had a deficit in their quality of life before surgery had a 3 times higher risk of a serious complication before leaving the hospital than patients who had normal quality of life (16% vs 6 %), independent of gender, race, tumor stage or laparoscopic or open colectomy. Patients with serious complications before leaving the hospital also were older and had more other medical problems than patients without complications. Further, patients who had a complication stayed in the hospital longer and their postoperative quality of life was worse

Medical Research: Were any of the findings unexpected?

Dr. Bingener: The influence of preoperative quality of life on postoperative complications has not previously described to my knowledge. It was surprising that a single question: ‘what is your overall quality of life’ would indeed be correlated to serious postoperative complications.

Medical Research: What should clinicians and patients take away from your report?

Dr. Bingener: Quality of life is a very important patient reported outcome that the surgical community is starting to utilize more. While some quality of life questionnaires may be lengthy and cumbersome, more recent instruments have been short. Practitioners may be able to integrate asking a single question (what is your overall quality of life, 1- 100) into their busy clinical day. Quality of life data may help us understand before surgery, which elderly patient with several different diseases is at higher risk for a postoperative complication and who may need additional care either before surgery or in the perioperative period.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Bingener: Others should confirm the results in other datasets. Further, we should investigate if we can improve preoperative quality of life, we certainly cannot change age or how many other diseases a person has. If we cannot improve quality of life, maybe we have to adjust our surgical recovery pathways to take extra care of patients we identify as at risk.


Perioperative Patient-Reported Outcomes Predict Serious Postoperative Complications: a Secondary Analysis of the COST Trial

Decreased survival after colon cancer surgery has been reported in patients with deficient preoperative quality of life. We hypothesized that deficits in preoperative quality of life are associated with postop…

Juliane Bingener, Jeff A. Sloan, Paul J. Novotny in Journal of Gastrointestinal Surgery (2014)

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