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P099. Is quality of life worse in operated Crohn's disease patients?


M. Barreiro-de Acosta1, M. Iglesias1, F. Caamaño1, A. Lorenzo Gonzalez1, J.E. Domíngez-Muñoz1

1University Hospital, Santiago de Compostela, Spain



Background: A high number of Crohn's disease (CD) patients need surgery during the evolution of the disease. It is well-known that health-related quality of life (HRQOL) is poorer in CD patients in relapse, but influence of previous surgery has not been assessed. The aim of this study was to assess if previous surgery was associated with a worse HRQOL in CD patients regardless of the activity of the disease.

Methods: A cross-sectional, prospective study with consecutive patient recruitment was designed. All adult patients with CD who attended the IBD Unit were included. Surgery related with CD was defined as small bowel and/or colonic resection; patients with exclusively perianal surgery were excluded. Remission was defined as a Harvey–Bradshaw score ≤4. To assess quality of life, we used in all patients the IBDQ-36 and SF-36 questionnaires. IBDQ-36 is a questionnaire with five dimensions (Bowel Symptoms, Systemic Symptoms, Functional Impairment, Social Impairment, and Emotional Function). The SF-36 includes Physical Functioning, Role-Physical, Bodily-Pain, General-Health, Vitality, Social Functioning, Role-Emotional and Mental-Health dimensions. Results are shown as mean and standard deviation; the t‑student test was used for comparing means.

Results: 323 patients were consecutively included (mean age of 39 years old and a mean of 10.5 years since diagnosis); 186 (57.6%) were female and 206 patients (63.8%) were in remission. 133 patients (41.2%) had suffered at least one surgical resection. Overall, in most of the dimensions from both questionnaires quality of life was better in previously-operated patients, but differences only were significant in Bodily Pain dimension of SF-36 (Surgery: 67.64±27.01 vs. Without surgery: 59.21±27.99) (p = 0.007). Analyzing the group of patients in remission, despite the fact that differences were not significant, we observed that in the IBDQ questionnaire, patients without previous surgery obtained a higher punctuation in all dimensions except in Systemic Symptoms (Surgery: 5.39±0.99 vs. Without surgery: 5.24±1.08) (p = n.s). On the contrary, in the SF-36 questionnaire, the punctuation was higher in the group of patients with previous surgery. In the subgroup of patients with relapse, surgically-intervened patients presented higher punctuations but again without statistically-notable differences.

Conclusions: Patients with previous surgery related to CD, independent of the activity of the disease, do not have worse quality of life than those that had never been operated.