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Life after per-oral endoscopic myotomy: long-term outcomes of quality of life and their association with Eckardt scores
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2018-02-02 , DOI: 10.1016/j.gie.2018.01.019
Yaseen B. Perbtani , Lazarus K. Mramba , Dennis Yang , Jorge Suarez , Peter V. Draganov

Background and Aims

The clinical efficacy of per-oral endoscopic myotomy (POEM) has been commonly established by reduction in the Eckardt score (<3) after the procedure. However, achalasia can lead to significant impairment in the patient’s quality of life that may go beyond the 4 classic achalasia symptoms as measured by the Eckardt score. The aims of our study were to evaluate the effect of POEM on short-term and long-term health-related quality of life (HRQOL) and to assess the association between HRQOL and Eckardt scores.

Methods

Single-center, prospective, cohort study of consecutive POEMs during a 3-year period. Eckardt and HRQOL scores as measured by the short-form survey questionnaire (SF-36) were obtained at baseline and at various intervals after POEM. Comparison of the mean scores was described by using univariate linear regression. The association between Eckardt scores and HRQOL were calculated by using a linear, mixed-model analysis.

Results

POEM was performed in 143 consecutive patients (54% male; mean ± standard deviation [SD] age, 56.9 ± 17.9 years). At long-term follow-up (mean 16.4 months, range 12-40), both the HRQOL baseline mental and physical component scores improved significantly from 61.5 ± 2.2 to 71.2 ± 3.6; (P < .021) and from 55.8 ± 2.2 to 63.6 ± 3.3; (P = < .034), respectively. Mixed-model analysis showed a significant association between Eckardt and all HRQOL scores (P < .001).

Conclusion

POEM improved all dimensions of HRQOL as measured by the SF-36 survey at both short-term and long-term follow-up. A strong association was seen between Eckardt scores and all HRQOL domains. Further studies with the use of disease-specific HRQOL instruments are warranted. (Clinical trial registration number: NCT01832779.)



中文翻译:

经口内镜下肌切开术后的生活:生活质量的长期结果及其与Eckardt评分的关系

背景和目标

手术后通常通过降低Eckardt评分(<3)来确定经口内镜下肌切开术(POEM)的临床疗效。但是,门失弛缓症可导致患者生活质量的重大损害,可能超出Eckardt评分所衡量的4种典型的门失弛缓症状。我们研究的目的是评估POEM对短期和长期健康相关生活质量(HRQOL)的影响,并评估HRQOL与Eckardt评分之间的关​​联。

方法

在3年内对连续POEM进行的单中心,前瞻性队列研究。在POEM后的基线和不同时间间隔内,通过简短调查表(SF-36)测量的Eckardt和HRQOL得分。使用单变量线性回归描述平均得分的比较。Eckardt评分与HRQOL之间的关联通过使用线性混合模型分析进行计算。

结果

POEM连续接受143例患者治疗(54%男性;平均±标准差[SD]年龄,56.9±17.9岁)。在长期随访中(平均16.4个月,范围12-40),HRQOL基线精神和身体成分评分均从61.5±2.2显着提高到71.2±3.6;(P  <.021)和55.8±2.2至63.6±3.3; (P  = <.034)。混合模型分析显示Eckardt与所有HRQOL得分之间存在显着相关性(P  <.001)。

结论

根据SF-36调查的短期和长期随访,POEM改善了HRQOL的所有方面。在Eckardt分数和所有HRQOL域之间发现了很强的关联。有必要对使用特定疾病的HRQOL仪器进行进一步的研究。(临床试验注册号:NCT01832779。)

更新日期:2018-02-02
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