Page 120 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

age at the time of operation (coefficient 1.8; CI 0.5 – 3.2; p=0.008). The other possible parameters, BMI (p=0.73), cardiac disease (p=0.09) and complications of GP (p=0.43), did not predict HRQoL.
Predictors of changes in HRQoL after GP.
Results of the mixed model of changes in HRQoL after GP are shown in Table 3b. Analysis showed that preoperative BMI was negatively associated with a postoperative increase in total HRQoL score (coefficient -2.5 points per kg/m2; CI -4.2 – -0.7; p=0.01). Children with lower BMI before operation showed a higher increase in postoperative HRQoL. In analysis of subdomains of HRQoL, the largest effect of BMI was found in the domain of psychosocial health (coefficient -3.8 points per kg/m2; CI -5.9 – -1.7; p=0.001). For change in physical health scores, preoperative BMI was not a significant predictor. Age (p=0.46), NI (p=0.66) and cardiac disease (p=0.79) were not predictive of postoperative change in HRQoL.
Table 3b. Mixed model analysis of postoperative increase in health-related quality of life (n=50).
increase in total HRQoL score
increase in Physical Health summary score
increase in Psychosocial Health summary score
Coefficient (Ci)
p-value
Coefficient (Ci)
p-value
Coefficient (Ci)
p-value
Age (years)
+0.4 (-0.6 – 1.4)
0.46
-0.2 (-1.7 – 1.2)
0.77
-0.05 (-1.2 – 1.1)
0.93
BMi (kg/m2)
-2.5 (-4.2 – -0.7)
0.01
-2.1 (-4.7 – 0.6)
0.12
-3.8 (-5.9 – -1.7)
0.001
ni (yes/no)
+2.1 (-7.5 – 11.7)
0.66
+4.7 (-9.5 – 18.8)
0.51
+2.3 (-9.1 – 13.6)
0.69
Cardiac (yes/no)
+2.6 (-17.2 – 22.4)
0.79
+6.0 (-23.2 – 35.2)
0.68
+3.9 (-19.5 – 27.2)
0.74
Legend: BMI body mass index; CI confidence interval; HRQoL health-related quality of life; NI neurologic impairment
Differences in self-report by patients versus proxy-report by caregivers
Eleven patients were able to self-report on their HRQoL (27.5%). There was no statistically significant difference between patients’ self-report and caregivers’ proxy-report of total HRQoL scores, although children scored their own HRQoL on average higher than their caregivers with a difference of 4.27 points (p=0.26).
DisCUssion
To our knowledge, this is the first study to prospectively investigate HRQoL after GP using validated questionnaires. Consequently, comparison to other published studies is limited.
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