GERD CLINICAL SIGNS AND SYMPTOMS SURVEY IS A VALID MARKER OF QUALITY OF LIFE IN PATIENTS UNDERGOING LAPAROSCOPIC HIATAL HERNIA REPAIR
R. Michael Cournoyer*, Daniel L. Davenport, Margaret A. Plymale, John S. Roth
Surgery, University of Kentucky, Indianpolis, KY
Background
Patients with hiatal hernia present with variable symptomatology which may impact the degree to which disease and post-operative recovery is perceived by the patient. Patient symptoms may be further impacted by factors such as diet and medication usage. In order to better interpret outcomes following laparoscopic hiatal hernia repair (LHHR), the GERD Clinical Signs and Symptoms Survey (GERD CSS) was developed. This 15-question survey measures patient-perceived symptomatology as well as diet and medication use. It has previously been shown that patients undergoing LHHR report improved symptoms and decreased dependence on medications on GERD CSS. This study evaluates the external validity of GERD CSS as a marker of health-related quality of life relative to the well-studied SF-36 Health Assessment in patients undergoing LHHR.
Methods
With IRB approval, retrospective analysis of patient-reported symptoms before LHHR and at the long-term postoperative period was conducted. The long-term postoperative period was defined as a minimum of 18 months following LHHR. Demographic data were abstracted. To facilitate data analysis, GERD CSS symptoms were categorized as regurgitation symptoms (regurgitation, heartburn, nausea); general abdominal symptoms (nausea, bloating, abdominal pain); bowel problems (constipation, diarrhea); and laryngeal symptoms (chronic cough, hoarseness). Preoperative and long-term postoperative GERD CSS scores were compared to SF-36 Health Assessment sub-constructs using Spearman's Rho correlations. Significance was set at p-values of <0.05.
Results
50 patients underwent LHHR. All patients were administered both GERD CSS and SF-36 Health Assessment at long-term postoperative follow-up. Median long-term postoperative follow-up was 28 months (range of 18-42 months). Postoperative symptom improvement as measured by the GERD CSS correlated with improved health-related quality of life as measured by SF-36. Reductions in regurgitation symptoms, abdominal symptoms, bowel symptoms, dysphagia symptoms and laryngeal symptoms all correlated with improved quality of life in various sub-constructs as measured by SF-36 (table 1).
Conclusions
The GERD Clinical Signs and Symptoms Survey is a valid indicator of quality of life in patients undergoing laparoscopic hiatal hernia repair and correlates with quality of life as measured by the SF-36 survey tool. As GERD CSS correlates positively with quality of life, this tool may be considered as a disease-specific tool to monitor patient outcomes following GERD treatment.
Back to 2019 Posters
