PMID- 28828517
OWN - NLM
STAT- MEDLINE
DCOM- 20180827
LR  - 20181202
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 42
IP  - 1
DP  - 2018 Jan
TI  - Impact of Abdominal Wall Hernias and Repair on Patient Quality of Life.
PG  - 19-25
LID - 10.1007/s00268-017-4173-6 [doi]
AB  - BACKGROUND: The modified Activities Assessment Scale (AAS) is a 13-question 
      abdominal wall quality of life (AW-QOL) survey validated in patients undergoing 
      ventral hernia repair (VHR). No studies have assessed AW-QOL among individuals 
      without abdominal wall pathology. The minimal clinically important difference 
      (MCID) of the modified AAS and its implications for the threshold at which VHR 
      should be offered also remain unknown. Our objectives were to (1) establish the 
      AW-QOL of patients with a clinical abdominal wall hernia versus those with no 
      hernia, (2) determine the MCID of the modified AAS, and (3) identify the baseline 
      quality of life (QOL) score at which patients derive little clinical benefit from 
      VHR. METHODS: Patient-centered outcomes data for all patients presenting to 
      General Surgery and Hernia Clinics October-December 2016 at a single safety-net 
      institution were collected via a prospective, cross-sectional observational study 
      design. Primary outcome was QOL measured using the modified AAS. Secondary 
      outcome was the MCID. RESULTS: Patients with no hernia had modified AAS scores of 
      81.6 (50.4-94.4), while patients with a clinically apparent hernia had lower 
      modified AAS scores of 31.4 (12.6-58.7) (p < 0.001). The MCID threshold was 7.6 
      for a "slight" change and 14.9 for "definite" change. Above a modified AAS score 
      of 81, the risk of worsening a patient's QOL by surgery is higher than the 
      chances of improvement. CONCLUSIONS: VHR can improve 1-year postsurgical AW-QOL 
      to levels similar to that of the general population. The MCID of the modified AAS 
      is 7.6 points. Patients with high baseline scores should be counseled about the 
      lack of potential benefit in QOL from elective VHR.
FAU - Cherla, Deepa V
AU  - Cherla DV
AUID- ORCID: 0000-0001-6367-8028
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA. deepa.cherla@uth.tmc.edu.
AD  - Center for Surgical Trials and Evidence-Based Practice, University of Texas 
      Health Science Center at Houston, Houston, TX, USA. deepa.cherla@uth.tmc.edu.
AD  - Department of Surgery, Lyndon Baines Johnson Hospital (affiliated with the 
      University of Texas Health Science Center at Houston), 5656 Kelley St, Houston, 
      TX, 77026, USA. deepa.cherla@uth.tmc.edu.
FAU - Moses, Maya L
AU  - Moses ML
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
FAU - Viso, Cristina P
AU  - Viso CP
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
FAU - Holihan, Julie L
AU  - Holihan JL
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
AD  - Center for Surgical Trials and Evidence-Based Practice, University of Texas 
      Health Science Center at Houston, Houston, TX, USA.
FAU - Flores-Gonzalez, Juan R
AU  - Flores-Gonzalez JR
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
FAU - Kao, Lillian S
AU  - Kao LS
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
AD  - Center for Surgical Trials and Evidence-Based Practice, University of Texas 
      Health Science Center at Houston, Houston, TX, USA.
FAU - Ko, Tien C
AU  - Ko TC
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
FAU - Liang, Mike K
AU  - Liang MK
AD  - Department of Surgery, University of Texas Health Science Center at Houston, 
      Houston, TX, USA.
AD  - Center for Surgical Trials and Evidence-Based Practice, University of Texas 
      Health Science Center at Houston, Houston, TX, USA.
LA  - eng
GR  - UL1 TR000371/NH/NIH HHS/United States
GR  - KL2 TR000370/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Abdominal Wall/surgery
MH  - Adult
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Elective Surgical Procedures/rehabilitation
MH  - Female
MH  - Health Surveys
MH  - Hernia, Ventral/psychology/*surgery
MH  - Herniorrhaphy/*rehabilitation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Outcome Assessment
MH  - Prospective Studies
MH  - Psychometrics
MH  - *Quality of Life
EDAT- 2017/08/23 06:00
MHDA- 2018/08/28 06:00
CRDT- 2017/08/23 06:00
PHST- 2017/08/23 06:00 [pubmed]
PHST- 2018/08/28 06:00 [medline]
PHST- 2017/08/23 06:00 [entrez]
AID - 10.1007/s00268-017-4173-6 [pii]
AID - 10.1007/s00268-017-4173-6 [doi]
PST - ppublish
SO  - World J Surg. 2018 Jan;42(1):19-25. doi: 10.1007/s00268-017-4173-6.