Abstract
BackgroundMost studies that follow up hepatectomy cases are limited in scope to an investigation of mortality and morbidity rates or the costs and length of hospital stay. In this study the authors aimed to characterize the quality of life and to evaluate mortality and its determinants after hepatectomy.MethodsThis prospective study was carried in a Post-Anaesthesia Care Unit (PACU) over 15 months, and 70 patients submitted to hepatectomy were enrolled. Demographic and peri-operative characteristics were evaluated for associations with mortality. At admission and 6 months after discharge, patients completed a Short Form-36 questionnaire (SF-36) and have their independence in Activities of Daily Living (ADL) was evaluated. Binary and multiple logistic regression analyses were used to evaluate of associations with mortality, and the Wilcoxon signed rank test was used to compare SF-36 scores before and after 6 months after hepatectomy.ResultsThe mortality rate was 19% at 6 months. Multivariate analysis identified postoperative delirium as an independent determinant for mortality. Six months after discharge, 46% patients stated that their health in general was better or much better than that 1 year previously. Six months after hepatectomy, patients had worse scores in the physical function domain of SF-36; however, scores for all the other domains did not differ. At this time point, patients were more dependent in instrumental ADL than before surgery (32% versus 7%, p = 0.027).ConclusionThis study identified postoperative delirium as an independent risk factor for mortality 6 months after hepatectomy. After 6 months, survivors were more dependent in instrumental ADL tasks and had worse scores in the physical function domain of SF-36.
Highlights
Most studies that follow up hepatectomy cases are limited in scope to an investigation of mortality and morbidity rates or the costs and length of hospital stay
Background some studies have documented the beneficial outcome after hepatectomy surgery, most have been limited in scope to mortality and morbidity rates, or cost and length of hospital stay (LOS) [1,2]
We found no differences in the dependency in P-Activities of Daily Living (ADL) and Lawton scores when comparing these variables before surgery and 6 months after discharge from the Post-Anaesthesia Care Unit (PACU)
Summary
Most studies that follow up hepatectomy cases are limited in scope to an investigation of mortality and morbidity rates or the costs and length of hospital stay. The Short-Form General Health Survey (SF-36) was developed during the Medical Outcomes Study (MOS) to measure generic health concepts that are relevant across age, disease and treatment groups [10]. It is a valid, self-completed questionnaire covering all aspects of Health Related Quality of Life (HRQOL); the Sf-36 has been used for post discharge ICU patients and for studying groups with other diseases; in addiction, it shows excellent reliability and validity [10,11]. This questionnaire has been culturally adapted to the Portuguese and validated in a study by Ferreira [12,13]
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