Evaluation of the Gastrointestinal Quality of Life Index as a System to Prioritize Patients on the Waiting List for Laparoscopic Cholecystectomy

Abstract

IntroductionWe prospectively evaluated health-related quality of life (HRQoL) through the gastrointestinal quality of life index (GIQLI) as a system to prioritize patients on the waiting list for laparoscopic cholecystectomy (LC) and its correlation with a linear prioritization system developed in the General and Gastrointestinal Surgery Institute of Clínica Quirón in Valencia. Materials and methodsThere were 100 consecutive patients who underwent elective outpatient LC.The main outcome measures consisted of: (1) assessment of the impact of the disease, measured through the GIQLI; (2) evaluation of an objective system based on technical scientific criteria; (3) evaluation of the utility of LC in improving HRQoL through the GIQLI by analyzing expected and obtained utility through the change ratio; and (4) analysis of the correlation between the objective linear system, HRQoL and utility. ResultsThe GIQLI was useful in evaluating the impact of the disease. LC significantly improved HRQoL in both oligosymptomatic and symptomatic patients. The objective or clinical factors did not allow perceptions of the process to be evaluated or the impact on HRQoL to be measured or inferred. A prioritization system based on GIQLI scores allows patients to be selected according to the expected utility (worsening of HRQoL) and obtained utility (improvement in HRQoL) of CL. ConclusionsPrioritization systems should include utility to guarantee equity. The GIQLI shows the impact of the disease on the patient while the clinical/objective factors are unrelated to the expectation of prioritization. Prioritization systems should include both elements to maintain the balance between impact and appropriate indication.