Long-Term Outcome and Quality of Life of Patients With Endometrial Carcinoma Treated With or Without Pelvic Radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) Trial

PurposeTo determine the long-term outcome and health-related quality of life (HRQL) of patients with endometrial carcinoma (EC) treated with or without pelvic radiotherapy in the Post Operative Radiation Therapy in Endometrial Carcinoma 1 (PORTEC-1) trial.Patients and MethodsBetween 1990 and 1997, 714 patients with stage IC grade 1 to 2 or IB grade 2 to 3 EC were randomly allocated to pelvic external-beam radiotherapy (EBRT) or no additional treatment (NAT). HRQL was evaluated with the Short Form 36-Item (SF-36) questionnaire; subscales from the European Organisation for Research and Treatment of Cancer (EORTC) PR25 module for bowel and bladder symptoms and the OV28 and CX24 modules for sexual symptoms; and demographic questions. Analysis was by intention-to-treat.ResultsMedian follow-up was 13.3 years. The 15-year actuarial locoregional recurrence rates were 5.8% for EBRT versus 15.5% for NAT (P < .001), and 15-year overall survival was 52% versus 60% (P = .14). Of the 351 patients confirmed to be alive with correct address, 246 (70%) returned the questionnaire. Patients treated with EBRT reported significant (P < .01) and clinically relevant higher rates of urinary incontinence, diarrhea, and fecal leakage leading to more limitations in daily activities. Increased symptoms were reflected by the frequent use of incontinence materials after EBRT (day and night use, 42.9% v 15.2% for NAT; P < .001). Patients treated with EBRT reported lower scores on the SF-36 scales “physical functioning” (P = .004) and “role-physical” (P = .003).ConclusionEBRT for endometrial cancer is associated with long-term urinary and bowel symptoms and lower physical and role-physical functioning, even 15 years after treatment. Despite its efficacy in reducing locoregional recurrence, EBRT should be avoided in patients with low- and intermediate-risk EC.

Download Full-text

P5598Long term outcome and quality of life following acute type A aortic dissection

European Heart Journal ◽

10.1093/eurheartj/ehz746.0542 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

E Sbarouni ◽

P Georgiadou ◽

M Manavi ◽

A Analitis ◽

C Beletsioti ◽

...

Keyword(s):

Quality Of Life ◽

Aortic Dissection ◽

Mental Component Summary ◽

Term Outcome ◽

Long Term Outcome ◽

Sf 36 ◽

Over Time

Abstract Introduction Acute aortic dissection (AAD) represents surgical emergency and current literature mainly consists of postoperative outcome reports. Long term outcome and quality of life have not extensively been investigated. Purpose This is a single center study to assess long term outcome and quality of life of patients who underwent emergency surgery for AAD. Methods From January 2007 until December 2009, 74 consecutive patients were operated for AAD type A in our hospital. Seventeen died during hospital stay and 12 died during follow-up. Mean follow up was 108±10 months. Seventeen patients refused to answer the SF-36 questionnaire; therefore our study group consists of 28 patients. The SF-36 Questionnaire was retrospectively obtained by phone calls, the first, fifth and tenth postoperative year and 2 summary scores are reported, physical (PCS) and mental (MCS). Results Our in-hospital mortality was 23%, late mortality 21.1% and the overall mortality was 39.2%. Significant differences in both physical and mental score over time were found among the 28 long-term survivors (Table). Both PCS and MCS at 1st, 5th and 10th year did not differ compared to age-matched general population but compared to subjects with one or more chronic diseases both PCS and MCS were both significantly better at 5yrs in our patients vs controls (p=0.0028 and p=0.0259, respectively). Likewise, at 5 years PCS but not MCS was better in comparison to subjects with a history of one hospitalization the preceding year (p=0.035 and p=0.1, respectively). Descriptive statistics of physical and mental component summary score over time Score 1 year (FU1) 5 years (FU2) 10 years (FU3) p-value Mean (SD) Mean (SD) Mean (SD) PCS 45.4 (7.7) 50.3 (7.0) 46.8 (9.2) 0.008* MCS 42.8 (15.1) 49.7 (12.7) 49.1 (12.3) 0.001** PCS, Physical component summary; *1 vs 5: p=0.003, 1 vs 10: p=0.469, 5 vs 10: p=0.027. MCS, Mental component summary; **1 vs 5: p=0.001, 1 vs 10: p=0.001, 5 vs 10: p=0.939. SD, standard deviation. Conclusion Quality of life improves after the 1st post-operative year and is comparable to healthy subjects. Although acute dissection is a catastrophic event with high mortality despite successful and timely repair, long term survival and quality of life on the long term are favorable.

Download Full-text

Development of PREPARE (PREdicting PAtients’ Long-Term Outcome for REcovery): A Practically Usable Prediction Model for Quality of Life of ICU Survivors

10.21203/rs.3.rs-52234/v1 ◽

2020 ◽

Author(s):

Nina Wubben ◽

Mark van den Boogaard ◽

Jordache Ramjith ◽

Laurens LA Bisschops ◽

Tim Frenzel ◽

...

Keyword(s):

Quality Of Life ◽

Prediction Model ◽

Term Outcome ◽

Long Term Outcome ◽

Icu Admission ◽

Sf 36 ◽

One Year ◽

Icu Physicians

Abstract BACKGROUND Though numbers of Intensive Care Unit (ICU) survivors have been increasing, using data on patient-reported long-term physical and mental functioning post-ICU during ICU admission is rare. Individualised information about long-term quality of life (QoL) supports ICU physicians’ decision making and empowers patients to better manage their disease during ICU admission and recovery and rehabilitation. We aimed to develop a prediction model for ICU survivors’ change in QoL one year after ICU admission. METHODS This is a sub-study of an ongoing multicenter prospective cohort study (MONITOR-IC study), in which long-term outcomes of ICU patients are measured up to five years after ICU admission. Adult patients admitted ≥12hrs to the ICU between July 2016 and January 2019 were included. Moribund patients were excluded. Multivariable linear regression and best subsets regression analysis (SRA) were used for building the prediction model. Change in QoL after one year was quantified using the EuroQol five-dimensional (EQ-5D-5L) questionnaire (Dutch range: -0.446–1), and Short-Form 36 (SF-36, range: 0-100). Models were internally validated RESULTS Data on 1308 ICU survivors was used to build the PREdicting PAtients’ long-term outcome for Recovery, PREPARE, prediction model. The best model contained 33 predictors, using the EQ-5D. Explained variance (R2) was 58.0%. Using SRA, we reduced the number of predictors to 5 (R2=55.3%): QoL before admission; sex; Clinical Frailty Scale; a cerebral embolism, occlusion, bleeding or infarction prevalent at or within one hour of admission; and having been admitted to the ICU from the operating room, from the same hospital’s nursing ward. The prediction model using the EQ-5D to quantify QoL had better predictive performance than the best SF-36 model (R2=40.6%).CONCLUSIONS We developed PREPARE, a prediction model for ICU survivors’ QoL one year after ICU admission that is practically usable due to the small number of predictors, measurable within the first 24 hours of admission. The next step is to test and evaluate the use of this prediction model in conversations between ICU physicians and patients and their families to ultimately improve patient outcomes. TRIAL REGISTRATION ClinicalTrials.gov: NCT03246334 on August 11, 2017.

Download Full-text

Long-term Outcome after Vegetative State due to Near-Drowning and Quality of Life of the Families

Neuropediatrics ◽

10.1055/s-0032-1307178 ◽

2012 ◽

Vol 43 (02) ◽

Author(s):

G Kluger ◽

A Kirsch ◽

M Hessenauer ◽

M Granel ◽

A Müller ◽

...

Keyword(s):

Quality Of Life ◽

Vegetative State ◽

Term Outcome ◽

Long Term Outcome ◽

Near Drowning

Download Full-text

Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas

Neurosurgical Review ◽

10.1007/s10143-021-01572-8 ◽

2021 ◽

Author(s):

Loay Shoubash ◽

Jörg Baldauf ◽

Marc Matthes ◽

Michael Kirsch ◽

Matthias Rath ◽

...

Keyword(s):

Quality Of Life ◽

Short Form ◽

Preoperative Evaluation ◽

Patient Counseling ◽

Surgical Morbidity ◽

Term Outcome ◽

Long Term Outcome

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.

Download Full-text

Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord ◽

10.1038/s41393-021-00659-9 ◽

2021 ◽

Author(s):

Florian Möller ◽

Rüdiger Rupp ◽

Norbert Weidner ◽

Christoph Gutenbrunner ◽

Yorck B. Kalke ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Independence ◽

Term Outcome ◽

Long Term Outcome ◽

Cord Injury ◽

Over Time

Abstract Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

Download Full-text

Affective Temperaments and Illness Severity in Patients with Bipolar Disorder

Medicina ◽

10.3390/medicina57010054 ◽

2021 ◽

Vol 57 (1) ◽

pp. 54

Author(s):

Mario Luciano ◽

Luca Steardo ◽

Gaia Sampogna ◽

Vito Caivano ◽

Carmen Ciampi ◽

...

Keyword(s):

Quality Of Life ◽

Bipolar Disorder ◽

Protective Factor ◽

Psychiatric Symptoms ◽

Control Group ◽

Term Outcome ◽

Long Term Outcome ◽

Affective Temperaments

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitationo of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.

Download Full-text

Long-term Outcome After Survival of a Cardiac Arrest: A Prospective Longitudinal Cohort Study

Neurorehabilitation and Neural Repair ◽

10.1177/1545968317697032 ◽

2017 ◽

Vol 31 (6) ◽

pp. 530-539 ◽

Cited By ~ 20

Author(s):

Véronique R. M. Moulaert ◽

Caroline M. van Heugten ◽

Ton P. M. Gorgels ◽

Derick T. Wade ◽

Jeanine A. Verbunt

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Cohort Study ◽

Anxiety And Depression ◽

Term Outcome ◽

Long Term Outcome ◽

Prospective Longitudinal ◽

Prospective Longitudinal Cohort

Background. A cardiac arrest can lead to hypoxic brain injury, which can affect all levels of functioning. Objective. To investigate 1-year outcome and the pattern of recovery after surviving a cardiac arrest. Methods. This was a multicenter, prospective longitudinal cohort study with 1 year of follow-up (measurements 2 weeks, 3 months, 1 year). On function level, physical/cardiac function (New York Heart Association Classification), cognition (Cognitive Log [Cog-log], Cognitive Failures Questionnaire), emotional functioning (Hospital Anxiety and Depression Scale, Impact of Event Scale), and fatigue (Fatigue Severity Scale) were assessed. In addition, level of activities (Frenchay Activities Index, FAI), participation (Community Integration Questionnaire [CIQ] and return to work), and quality of life (EuroQol 5D, EuroQol Visual Analogue Scale, SF-36, Quality of Life after Brain Injury) were measured. Results. In this cohort, 141 cardiac arrest survivors were included. At 1 year, 14 (13%) survivors scored below cutoff on the Cog-log. Both anxiety and depression were present in 16 (15%) survivors, 29 (28%) experienced posttraumatic stress symptoms and 55 (52%), severe fatigue. Scores on the FAI and the CIQ were, on average, respectively 96% and 92% of the prearrest scores. Of those previously working, 41 (72%) had returned to work. Most recovery of cognitive function and quality of life occurred within the first 3 months, with further improvement on some domains of quality of life up to 12 months. Conclusions. Overall, long-term outcome in terms of activities, participation, and quality of life after cardiac arrest is reassuring. Nevertheless, fatigue is common; problems with cognition and emotions occur; and return to work can be at risk.

Download Full-text