P283. Long-term impacts of colectomy surgery among ulcerative colitis patients study (LOCUS): A preliminary analysis
C. Brown1, P. Gibson2, A. Hart3, G. Kaplan4, E. Hautamaki5, E. Flood5, T. Fan6, L. Stokes6, K. Beusterien5
1Providence Health Care St. Paul's Hospital, Division of General Surgery, Vancouver, Canada; 2The Alfred Hospital, Department of Gastroenterology, Melbourne, Australia; 3St. Mark's Hospital NWLH NHS Trust, IBD Unit, London, United Kingdom; 4University of Calgary, Departments of Medicine and Community Health Sciences, Calgary, Canada; 5Oxford Outcomes Inc., Bethesda, United States; 6Merck & Co. Inc., Whitehouse Station, United States
Background: A host of potential post-operative complications and lifestyle changes may impact health-related quality of life (HRQL) among ulcerative colitis (UC) patients who underwent colectomy surgery. The objective of LOCUS is to evaluate the long-term consequences of colectomy from the patient's perspective.
Methods: A cross-sectional survey is being conducted at clinical centers in Canada (n = 3), Australia (n = 6), and the UK (n = 3), assessing a representative cohort of 515 adult patients with UC who underwent colectomy at least one year prior to study enrollment. Patients are asked to complete a Web-based survey (or paper survey) containing a battery of measures, including the Inflammatory Bowel Disease Questionnaire (IBDQ), Hospital Anxiety and Depression Scale (HADS), EQ-5D, and scales assessing sexual functioning and fertility, work productivity, dietary restrictions, and preferences/satisfaction. Colectomy-related surgeries and any complications are recorded from medical charts.
Results: To date, 41 patients have completed the questionnaire (mean age of 39 + 11 years; mean of 1,612 + 680 days since first colectomy surgery; and 46% are male). They report having an average of 7.4 stools per day, and 34% are currently taking medications for their bowel disease; 11 (27%) experienced complications with their pouch. On average, patients' general HRQL improved after colectomy; however, patients may experience psychological, sexual, and body image impacts. Specifically, the mean MOS Sexual Functioning scale scores for women was 47 (range 0100 higher worse) compared to the population mean of 25; 5% report having difficulty conceiving. HADS scores reveal 5% and 22% with mild and severe anxiety, respectively, and 5% and 5% with mild and severe depression, respectively. The mean body image scale score was 10.0 (range 520; higher worse). The mean EQ-5D index score was 0.73 + 0.3 (general population = 0.92).
Conclusions: Interim analyses from the LOCUS study show that although patients' HRQL improved after colectomy, patients' long-term quality of life may be impacted, particularly in psychological status, sexual functioning, and complications of surgery. Also, a significant proportion of these patients still need to take medications to control symptoms or for complications. The study will help inform both physician and patient understanding with respect to expectations with colectomy.