Disease phenotype rather than treatment strategy impacts the long-term quality of life in patients with diverticular disease
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To identify the impact of the severity of diverticular disease on long-term quality of life.
Consecutive patients, hospitalized between October 2009 and November 2015 due to uncomplicated (UD) and complicated diverticulitis (CD) of the left colon, were analyzed. Patients undergoing emergent surgery for perforated disease were excluded. Primary endpoint was health-related quality of life (HrQol), measured by the Short Form 36 questionnaire (SF-36). Physical (PCS) and mental (MCS) compository scores were calculated from SF-36 subscales. To overcome bias, one-to-one propensity score matching and multivariable logistic regression analysis were performed.
Two hundred eighty of the overall 392 patients (Male 138, Female 142; mean age 60.5 years, range 27–91) answered the SF-36 questionnaire. The median follow-up period was 37.8 months (range 15–85). After propensity score matching, each group consisted of 51 patients. Results of the SF-36 questionnaires showed a statistically significant difference, favoring patients with CD in 5 of 8 domains. Also, PCS (56.3 vs. 52.9, p = 0.13) and MCS (53.3 vs. 46.7, p = 0.005) were higher in patients treated for CD. By a multivariate analysis, complicated disease was independently associated with a better scoring on 6 out of 8 SF-36 subscales and on MCS. Treatment strategy (surgery or conservative) did not have any impact on SF-36 subscales, MCS, or PCS on multivariate analysis.
In contrast to complicated disease, the uncomplicated diverticular disease is associated with an impaired long-term quality of life especially in domains composing mental health scores independently of chosen treatment strategy.
The study is registered with the Research Registry at June 19, 2019.
Research registry UIN: researchregistry4959.
KeywordsQuality of life Diverticular disease Conservative treatment Elective surgery
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study protocol was in accordance with the Declaration of Helsinki and approved by the medical ethics board of the Bavarian medical council.
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