Short-term patient-reported quality of life after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation.

Abstract

OBJECTIVE:

To determine the short-term health status of patients after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation (CARE). Radical cystectomy and urinary diversion in patients with invasive bladder cancer can have a significant effect on patients' quality of life.

METHODS:

A total of 91 patients completed the CARE preoperatively and postoperatively. The CARE scores were calculated from postoperative day 7 to 90. Outcome measures were calculated using the CARE difference index (CDI), defined as the difference between the baseline CARE and postoperative day 7 CARE scores. The primary outcome was the time taken to recover 90% of the CDI.

RESULTS:

The mean age at robot-assisted radical cystectomy was 69 years (range 42-86). Of the 91 patients, 68 (74%) were men, 38 underwent extracorporeal urinary diversion, 52 underwent intracorporeal urinary diversion, and 1 underwent no diversion. A comparison of the preoperative and postoperative day 7 scores demonstrated a 48% decline in the total CARE score. The decline in specific CARE domains was 14%, 34%, 56%, and 66% against baseline for the cognition, pain, gastrointestinal, and activity domains, respectively. The mean time to recover 90% of the CDI for the total CARE score was 63 days. The mean time to recover 90% of the CDI for the pain, cognition, and activity domains was 33, 57, and 82 days, respectively. Patients did not recover 90% of the CDI for the gastrointestinal domain within the 90-day follow-up period.

CONCLUSION:

Patients who underwent robot-assisted radical cystectomy approached preoperative baseline levels within 90 days using the CARE in the total CARE, pain, cognition, and activity domains but not in the gastrointestinal domain.

• Authors: Andrew Stegemann, Shabnam Rehman, Katie Brewer, Tushar Kesavadas, Abid Hussain, Rameela Chandrasekhar, Gregory E Wilding, Khurshid A Guru
• Journal: Urology (Urology) Vol. 79 Issue 6 Pg. 1274-9 (Jun 2012) ISSN: 1527-9995 [Electronic] United States
• PMID: 22521192 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Convalescence
• Cystectomy (methods)
• Female
• Health Status
• Humans
• Male
• Middle Aged
• Quality of Life
• Robotics
• Urinary Diversion