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Health-related quality of life in patients undergoing adrenalectomy: report from a Swedish National Audit.

ABSTRACT: PURPOSE:The aim of the study was to examine subjective health-related quality of life (HRQoL) in patients undergoing adrenalectomy. METHODS:The study included patients scheduled for adrenalectomy 2014-2017 after giving informed consent. The SF-36 questionnaire was administrated before operation and 1 year postoperatively. Results were compared with published normative values in Sweden. RESULTS:Some 50 patients were included. SF-36 scores for the whole cohort improved significantly after adrenalectomy in all dimensions except for bodily pain. Compared with the general Swedish population, the patients reported a significantly reduced HRQoL before and after adrenalectomy in all domains except for bodily pain postoperatively. Patients with benign functional tumours had lower HRQoL in physical domains before adrenalectomy than patients with benign non-functional tumours; Physical Component Summary (PCS), median 33.1 (range 17.1-62.9) vs. 44.2 (20.0-66.5), p = 0.018. Postoperatively, HRQoL was similar in the two groups of patients. Patients with benign functional tumours reported significantly improved HRQoL in all dimensions after adrenalectomy: PCS 33.1 (17.1-62.9) preoperatively vs. 47.6 (19.8-57.3) postoperatively, p = 0.005; Mental Component Summary (MCS) 33.8 (11.8-62.0) preoperatively vs. 52.7 (16.4-59.8) postoperatively, p = 0.004. These improvements were not seen in patients with benign non-functional or malignant tumours. Patients with malignant tumours reported no difference in SF-36 scores before or after adrenalectomy compared with patients with benign non-functional tumours. CONCLUSIONS:Adrenalectomy improved HRQoL in patients with benign functional tumours. Adrenalectomy did not improve HRQoL in patients with benign non-functional tumours or in patients with malignant tumours.

SUBMITTER: Thompson LH

PROVIDER: S-EPMC6908554 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Health-related quality of life in patients undergoing adrenalectomy: report from a Swedish National Audit.

Thompson Lo Hallin LH Nordenström Erik E Almquist Martin M Bergenfelz Anders A

Langenbeck's archives of surgery 20191126 7

<h4>Purpose</h4>The aim of the study was to examine subjective health-related quality of life (HRQoL) in patients undergoing adrenalectomy.<h4>Methods</h4>The study included patients scheduled for adrenalectomy 2014-2017 after giving informed consent. The SF-36 questionnaire was administrated before operation and 1 year postoperatively. Results were compared with published normative values in Sweden.<h4>Results</h4>Some 50 patients were included. SF-36 scores for the whole cohort improved signif ...[more]

PMID: 31773244

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Project description:BackgroundEvidence for the association between social determinants of health (SDoH) and health-related quality of life (HRQoL) is largely based on single SDoH measures, with limited evaluation of cumulative social disadvantage. We examined the association between cumulative social disadvantage and the Health and Activity Limitation Index (HALex).MethodsUsing adult data from the National Health Interview Survey (2013-2017), we created a cumulative disadvantage index by aggregating 47 deprivations across 6 SDoH domains. Respondents were ranked using cumulative SDoH index quartiles (SDoH-Q1 to Q4), with higher quartile groups being more disadvantaged. We used two-part models for continuous HALex scores and logistic regression for poor HALex (< 20th percentile score) to examine HALex differences associated with cumulative disadvantage. Lower HALex scores implied poorer HRQoL performance.ResultsThe study sample included 156,182 respondents, representing 232.8 million adults in the United States (mean age 46 years; 51.7% women). The mean HALex score was 0.85 and 17.7% had poor HALex. Higher SDoH quartile groups had poorer HALex performance (lower scores and increased prevalence of poor HALex). A unit increase in SDoH index was associated with - 0.010 (95% CI [-0.011, -0.010]) difference in HALex score and 20% higher odds of poor HALex (odds ratio, OR = 1.20; 95% CI [1.19, 1.21]). Relative to SDoH-Q1, SDoH-Q4 was associated with HALex score difference of -0.086 (95% CI [-0.089, -0.083]) and OR = 5.32 (95% CI [4.97, 5.70]) for poor HALex. Despite a higher burden of cumulative social disadvantage, Hispanics had a weaker SDoH-HALex association than their non-Hispanic White counterparts.ConclusionsCumulative social disadvantage was associated with poorer HALex performance in an incremental fashion. Innovations to incorporate SDoH-screening tools into clinical decision systems must continue in order to accurately identify socially vulnerable groups in need of both clinical risk mitigation and social support. To maximize health returns, policies can be tailored through community partnerships to address systemic barriers that exist within distinct sociodemographic groups, as well as demographic differences in health perception and healthcare experience.

Dataset Information

Health-related quality of life in patients undergoing adrenalectomy: report from a Swedish National Audit.

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Health-related quality of life in patients undergoing adrenalectomy: report from a Swedish National Audit.

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