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Published on: December 23, 2022
Patient-reported outcomes in hernia repair
E M Bitzer1, C Lorenz, S Nickel
1ISEG, Institute for Social Medicine, Epidemiology and Health System Research, Hannover, Germany. bitzer@iseg.org
Summary
Patient-reported outcomes (PROs) show groin hernia repair quality improves significantly six months post-surgery. Pre-operative health status and age are key predictors of recovery, highlighting the need for prospective measurements in quality improvement.
Area of Science:
- Surgical Quality Improvement
- Patient-Reported Outcomes Research
- Health Services Research
Background:
- Assessing the feasibility of a quality improvement system using patient-reported outcomes (PROs) for short-stay groin hernia repair.
- Investigating patient recovery and quality of life after surgical intervention.
Purpose of the Study:
- To evaluate the effectiveness of a PRO-based quality improvement system in short-stay groin hernia repair.
- To identify key factors influencing post-operative outcomes.
Main Methods:
- Surveyed patients undergoing hernia repair across two centers (August 1999 - January 2002).
- Collected data on health-related quality of life (SF-36) and symptoms (Hernia Symptom Checklist, HSCL) pre-operatively (T0) and at 14 days (T1) and 6 months (T2) post-operatively.
- Analyzed main outcomes (SF-36 subscales: physical functioning, bodily pain, role physical; HSCL at T2) using generalized linear models.
Main Results:
- 342 patients included; T2 response rate was 54.1%.
- Significant improvement in symptoms (HSCL) and quality of life (SF-36 subscales) from T1 to T2 (P < 0.001).
- Pre-operative health status, age, and self-reported post-operative complaints significantly influenced outcomes.
Conclusions:
- Despite a low response rate, PRO data provided meaningful insights for quality improvement in hernia repair.
- Prospective pre-post measurements are crucial for institutional comparisons, as pre-operative status is a major determinant of outcomes.
- Addressing low response rates, potentially due to questionnaire delivery during routine visits, is essential for robust PRO data collection.