Photo Credit: sefa ozei
The following is a summary of “Impact of Postoperative Complications on Recovery of Health-Related Quality of Life and Functional Capacity After Pancreatectomy: Findings From a Prospective Observational Study,” published in the November 2024 issue of Surgery by Pecorelli et al.
Pancreatic surgery is often associated with severe postoperative morbidity, which can negatively affect recovery. However, limited and conflicting data exist regarding the effect of these complications on health-related quality of life (HRQoL).
Researchers conducted a prospective study evaluating the impact of postoperative complications on HRQoL and survival after pancreatic surgery.
They involved consecutive patients who underwent elective pancreatectomy (2020 to 2022). Patients completed the Patient-Reported Outcomes Measurement Information System (PROMIS-29) profile and Duke Activity Status Index (DASI) questionnaires to assess HRQoL and functional capacity before surgery and on postoperative days 15, 30, 90, and 180. Multivariable linear regression was used to determine mean differences in HRQoL scores, adjusting for preoperative scores and confounders.
The results showed 528 patients, 370 (70%) experienced postoperative morbidity within 90 days, and 154 (29%) had severe complications (Clavien-Dindo grade >2). Delayed gastric emptying had the greatest impact on HRQoL, decreasing mental health up to postoperative day 90 and physical health up to day 180 compared with uncomplicated patients. An inverse relationship between complication severity and HRQoL was observed for most domains, with patients experiencing Clavien-Dindo grade 3b to 4 complications showing worse HRQoL and functional capacity up to 6 months after surgery. Among 235 patients with pancreatic cancer, those with grade 3b and 4 complications had reduced disease-specific survival (median survival of 25 months vs. 41 months, P<0.001).
They concluded that postoperative complications significantly impair HRQoL and functional capacity, with a dose-effect relationship between complication severity and the impairments.
