RESUMO
BACKGROUND: Patient satisfaction of scar quality and their influence on health-related quality of life (HRQoL) have never been investigated in morbidly obese patients. OBJECTIVES: Our objectives were (1) to assess scar quality 1 year post laparoscopic bariatric surgery by means of the Patient and Observer Scar Assessment Scale (POSAS), and (2) to examine the influence of patients' perception of scar quality on patients' HRQoL. SETTING: A large Bariatric Center of Excellence in the Netherlands. METHODS: This was a descriptive pilot study of patients who underwent primary laparoscopic bariatric surgery. One year after surgery, patients and 2 observers completed the POSAS. HRQoL was assessed by using the RAND-36. Agreement of POSAS scores between patients and observers was calculated with intraclass correlation coefficient. Correlations between POSAS scores and HRQoL scores were calculated with Spearman's rho. RESULTS: A total of 50 patients were included. Patients scored their scar quality worse than observers (21 versus 15-16), particularly on visual parameters (4-5 versus 2-3). Patients and observers showed poor agreement on all POSAS items (intraclass correlation coefficient = .16-.32). No significant correlations were detected between POSAS and HRQoL scores. CONCLUSION: While patient scar quality satisfaction was relatively low after bariatric surgery, these outcomes were not correlated with HRQoL. Bariatric surgeons should be aware that patients could have a different view on scar quality compared with them. This realization is important to manage patient expectations regarding scar quality after bariatric surgery. Effective communication may improve patient satisfaction as an outcome.
Assuntos
Cirurgia Bariátrica/psicologia , Cicatriz/psicologia , Laparoscopia/psicologia , Obesidade Mórbida/cirurgia , Satisfação do Paciente , Adulto , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/instrumentação , Feminino , Gastrectomia/efeitos adversos , Gastrectomia/instrumentação , Gastrectomia/psicologia , Derivação Gástrica/efeitos adversos , Derivação Gástrica/instrumentação , Derivação Gástrica/psicologia , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/instrumentação , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Variações Dependentes do Observador , Projetos Piloto , Qualidade de Vida , Instrumentos Cirúrgicos/efeitos adversos , Inquéritos e Questionários , Redução de Peso/fisiologia , Adulto JovemRESUMO
Simultaneous bilateral hip fractures are rare, mostly being caused by violent forces or in patients with bone metabolism disorders. We present the case of an elderly patient who sustained simultaneous bilateral hip fractures following a simple fall without having any known predilecting comorbidities other than advanced age. Only four cases have been described of elderly patients without comorbidity with simultaneous bilateral hip fractures following low-energy traumas. This rareness potentially leads to misses of this diagnosis.