scholarly journals Chronic Postsurgical Pain After Minimally Invasive Adrenalectomy: Prevalence and Impact on Quality of Life

Author(s):  
Esmee V. van Helden ◽  
Allon van Uitert ◽  
Kim I. Albers ◽  
Monique A.H. Steegers ◽  
Henri J.L.M. Timmers ◽  
...  

Abstract Background. Minimally invasive adrenalectomy is the standard of care for small adrenal tumours. Both the transperitoneal lateral approach and posterior retroperitoneal approach are widely used and have been proven to be safe and effective. However, the prevalence of chronic postsurgical pain has not been specifically investigated in previous studies. The primary goal of this study was to identify the prevalence of chronic postsurgical pain after minimally invasive adrenalectomy. Methods. A cross-sectional study was performed among all consecutive patients who had undergone minimally invasive adrenalectomy in a single university medical centre. The primary outcome was the prevalence of chronic postsurgical pain. Secondary outcomes were the prevalence of localized hypoesthesia, risk factors for the development of chronic postsurgical pain, and the Health-Related Quality of Life. Three questionnaires were used to measure the prevalence and severity of chronic postsurgical pain, hypoesthesia, and Health-Related Quality of Life. Logistic regression analysis was performed to determine risk factors for development of chronic postsurgical pain. Results. Six hundred two patients underwent minimally invasive adrenalectomy between January 2007 and September 2019, of whom 328 signed informed consent. The prevalence of chronic postsurgical pain was 14.9%. Young age was a significant predictor for developing chronic postsurgical pain. The prevalence of localized hypoesthesia was 15.2%. In patients with chronic postsurgical pain, Health-Related Quality of Life was significantly lower, compared to patients without pain. Conclusions. The prevalence of chronic postsurgical pain following minimally invasive adrenalectomy is considerable. Furthermore, the presence of chronic postsurgical pain was correlated with a significant and clinically relevant lower Health-Related Quality of Life. These findings should be included in the preoperative counselling of the patient. In the absence of evidence for effective treatment in established chronic pain, prevention should be the key strategy and topic of future research.

2020 ◽  
Vol 27 (09) ◽  
pp. 1976-1982
Author(s):  
Subhan Ullah ◽  
Zubash Aslam ◽  
Ghulam Abbas Shiekh

Objectives: To determine the risk factors of depressive disorders and health related quality of life among adult patients of depression presenting at psychiatric OPD clinic of Aziz Fatima Hospital Faisalabad. Study Design: Cross-sectional study. Setting: Psychiatric OPD clinic of Aziz Fatima Hospital Faisalabad Pakistan. Period: 1st August 2019 to 31st December 2019. Material & Method: 150 patients for the screening of depression Patient Health Questionnaire (PHQ) was used. For measuring health related quality of life World Health Organization Quality of Life (WHOQOL-Brief) was used. Results: It was found that out of 150 patients with depressive disorder 104(69.3%) were female and 46(30.7%) were male patients. Findings of the study assessed that depressive disorder not only impacts on the patients' mood but it also impairs the individuals overall perception of their general health, physical health, psychological wellbeing, social relationship and also distorted perception of their surrounding psychosocial environment. Conclusion: Depressive disorder is common in patients visiting psychiatric OPD clinic and findings of study suggested that age, education level, socio-economic status, death of parent at early age, unemployment, workplace issues, parental separation, loss of partner and family history of depression are important demographic variables which plays the role of significant risk factor for depression and impairs the quality of life among depressive patients.


2020 ◽  
Author(s):  
Ana Stefancic ◽  
Nathaniel Lu ◽  
Xiaoyan Wang ◽  
Lauren Bochicchio ◽  
Christopher Weatherly ◽  
...  

Abstract Background: Given indications of widening disparities in mortality for people with serious mental illness, understanding and reducing their risk of cardiovascular disease (CVD) and improving health-related quality of life is an urgent public health priority. This study examined CVD risk factor clustering, health-related quality of life (HRQoL), and their correlates among people with SMI who were overweight/obese (i.e., BMI ≥ 25) and living in supportive housing. Methods: Baseline data were used from participants enrolled in a clinical trial examining the effectiveness of a peer-led healthy lifestyle program. univariate analyses were used to describe the distribution of individual risk factors and the cumulative number of CVD risk factors. Bivariate and regression analyses were used to explore correlates of individual CVD risk factors, the cumulative number of risk factors, and HRQoL Physical and Mental Health Composite Scores. Results: Participants were 48.7 years old, on average (sd = 11.6) and the majority identified as male (57.3%) and as racial/ethnic minorities (82%; primarily non-Hispanic black). Most participants (75.4%) had at least two co-occurring CVD risk factors and almost half (46.7%) had three or more, most commonly obesity, smoking, and hypertension. Prevalence of individual risk factors, particularly smoking and diabetes, varied by demographic and clinical characteristics. Identifying as female, older age, and taking second generation antipsychotic medication were associated with having more co-occurring CVD risk factors, while having completed high school was associated with fewer risks. Number of co-occurring CVD risk factors, identifying as female, and greater psychiatric symptoms were negatively associated with physical HRQoL. Older age, lower psychiatric symptoms, and greater internal locus of control were positively associated with mental HRQoL.Conclusion: Even when compared to other studies examining CVD risk among individuals diagnosed with schizophrenia, our study sample generally had higher rates of clustering of multiple risk factors, highlighting the need for urgent intervention among those living in supportive housing. Demographic and clinical factors further identify those who may have the highest risk as well as factors that may adversely affect perceived health status and functioning. Reducing CVD risk and improving HRQoL will likely require expanding access to quality care, adapting intervention approaches to subpopulations, and providing increased support to facilitate health behavior change and perceived control for modifiable risk factors.Trial Registration: This trial was registered through ClinicalTrials.gov on June 26, 2014. The registration number is NCT02175641.


Author(s):  
Shuang Ao ◽  
Yu Liu ◽  
Yu Wang ◽  
Hao Zhang ◽  
Hui Leng

Abstract Background Cervical kyphosis has been pointed out in asymptomatic populations. The purposes of this study were (1) to investigate the incidence of cervical kyphosis in asymptomatic populations, (2) to identify risk factors related to cervical kyphosis, and (3) to assess the relationship between cervical kyphosis and health-related quality of life (HRQOL). Methods A cohort of 235 asymptomatic volunteers’ records was retrospectively analyzed. Radiographic parameters of the coronal and sagittal planes were measured in the full-length spine x-ray. All patients were classified into two groups based on the cervical lordosis angle: cervical lordosis (CL) and cervical kyphosis (CK). HRQOL was evaluated by EQ-5D and SF-36 (PCS and MCS) questionnaires. Results CK was observed in 90 of 235 (38.3%) participants. There was a significant difference with regard to age between volunteers with CK and CL (32.23 ± 8.12 vs. 42.12 ± 6.14, p < 0.05). Several parameters had a significant relationship with CK, including TK, T1 slope, TIA, SVA, and CT. Logistic regression analysis identified age, TK, T1 slope, and SVA as independent risk factors of CK. In addition, there was a negative correlation between CK and the parameters of HRQOL (EQ-5D, − 0.63; PCS, − 0.68; MCS, − 0.59). Conclusions The incidence of CK in normal populations is 38.3%. Some spinal parameters are related to CK. CK is associated with the HRQOL.


2019 ◽  
Vol 26 (13) ◽  
pp. 1386-1395 ◽  
Author(s):  
Joy Van de Cauter ◽  
Dirk De Bacquer ◽  
Els Clays ◽  
Delphine De Smedt ◽  
Kornelia Kotseva ◽  
...  

Background Coronary heart disease (CHD) can lead to loss of workability and early retirement. We aimed to investigate return to work (RTW) and its relationship towards psychosocial well-being and health-related quality of life (HRQoL). Design Secondary analyses were applied to cross-sectional data from the EUROASPIRE IV survey (European Action on Secondary and Primary prevention through Intervention to Reduce Events). Methods Participants were examined and interviewed at 6–36 months following the recruiting event. Psychosocial well-being and HRQoL were evaluated by completing the ‘Hospital Anxiety and Depression Scale’ and ‘HeartQoL’ questionnaire. Using generalised mixed models, we calculated the odds ratios for RTW. Depression, anxiety and adjusted means of HeartQoL were estimated accounting for RTW. Results Out of 3291 employed patients, the majority (76.0%) returned to work, of which 85.6% were men, but there was a general underrepresentation of women. Young ( p < 0.001), high-educated ( p < 0.001) patients without prior cardiovascular events ( p < 0.05) were better off regarding RTW. No significant associations with CHD risk factors and cardiac rehabilitation were established. Those that rejoined the workforce were less susceptible to psychosocial distress (anxiety/depression, p < 0.001) and experienced a better quality of life ( p < 0.001). Conclusion These findings provide evidence that non-modifiable factors (sociodemographic factors, cardiovascular history), more than classical risk factors, are associated with RTW, and that patients who resume work display better psychosocial well-being and HRQoL. Our results illustrate a need for tailored cardiac rehabilitation with a focus on work-related aspects, mental health and HRQoL indicators to reach sustainable RTW, especially in vulnerable groups like less educated and elderly patients.


2018 ◽  
Vol 18 (9) ◽  
pp. 1612-1624 ◽  
Author(s):  
Thamrong Lertudomphonwanit ◽  
Michael P. Kelly ◽  
Keith H. Bridwell ◽  
Lawrence G. Lenke ◽  
Steven J. McAnany ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S515-S516
Author(s):  
Lan Doan ◽  
Yumie Takata ◽  
Karen Hooker ◽  
Carolyn Mendez-Luck ◽  
and Veronica L Irvin

Abstract Cardiovascular disease (CVD) is the leading cause of death for Asian American (AA), Native Hawaiian, and Pacific Islander (NHPI) older adults, and AAs/NHPIs have not enjoyed decreases in CVD mortality rates, as have non-Hispanic whites (NHWs). Heterogeneity exists in the prevalence of traditional CVD risk factors for AAs/NHPIs. Health-related quality of life (HRQOL) reflect physical and mental burdens beyond clinical burdens, which may help explain discrepant CVD rates and risk factors in AAs/NHPIs. We examined HRQOL among NHW and AA/NHPI Medicare Advantage enrollees with and without a CVD (i.e., coronary artery disease, congestive heart failure, myocardial infarction, and stroke) using the Medicare Health Outcomes Survey. The sample included 655,914 older adults who were 65 years or older, self-reported as AA/NHPI or NHW, and were enrolled in Medicare Advantage plans in 2011-2015. HRQOL was measured using the Veterans RAND 12-item survey and is composed of a physical component score (PCS) and mental component score (MCS), where higher scores reflect better physical and mental health, respectively. Multivariable linear regression was used to explore HRQOL and CVD prevalence. Asian Indian, Filipino, Vietnamese, Other Asian, and NHPI subgroups had lower overall PCS, and all AA/NHPI subgroups had lower overall MCS, compared to NHWs. Among those reporting having any CVD, PCS varied by CVD outcomes and subgroups, whereas MCS was lower for all CVD outcomes and for all but one AA/NHPI subgroups (Japanese), compared to NHWs. Attention to mental health for AA/NHPI older adults could be important for the equitable realization of healthy aging.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ling-chen Huang ◽  
Dao-zhong Chen ◽  
Liang-wan Chen ◽  
Qi-chen Xu ◽  
Zi-he Zheng ◽  
...  

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