Quality of Life in Long-Term Survivors of Surgical Necrotizing Enterocolitis.

ABSTRACT

OBJECTIVE: This study evaluated the quality of life (QoL) in patients who have recovered from surgical necrotizing enterocolitis (NEC). METHODS: This is a cross-sectional study conducted in a tertiary centre and patients who have received surgery for NEC between 2000 and 2014 were invited to participate. The Pediatric Quality of Life Inventory Generic (PedsQL™) Core Scale Version 4.0 was used as the assessment tool. Values were reported as median (interquartile rage) and compared with age-matched controls. RESULTS: During the study period, 90 patients were eligible for the study and 29 patients have completed the survey. There was no gender difference and the median age was 10 years (9-13 years). Nine patients have suffered from short bowel syndrome (SBS) as a result of the surgery. For the QoL assessment, 17 participants have completed both parent proxy and child-rated survey; 11 completed the parent-rated survey and 1 completed child-rated survey only. The scores for parent-rated survey were - overall 86.4 (70.7-92.7); physical 95.3 (83.6-100) and psychosocial 82.5 (66.3-90.4). The scores for child-rated survey were - overall 82.1 (73.4-96.2); physical 96.9 (90.6-99.2) and psychosocial 81.7 (64.2-95.8). Regarding the impact of previous SBS on the QoL, there were no significant difference in the overall score for both parent proxy and child-rated survey (SBS-ve vs + ve) (parent-rated 87.5 vs 85.3, p = 0.849; child-rated 81.0 vs 88.0, p = 0.503). There were also no differences in physical and psychosocial assessments (parent-rated [physical] 95.3 vs 95.3, p = 0.267; [psychosocial] 84.2 vs 80.0, p = 0.274; child-rated [physical] 95.3 vs 96.9, p = 0.395; [psychosocial] 79.2 vs 87.5, p = 0.611). CONCLUSION: The QoL in long-term survivors of surgical NEC without major medical illnesses is comparable to normal population. However, they may have a lower psychosocial well-being that should be addressed. Previous history of SBS does not have a significant impact on the future QoL. LEVEL OF EVIDENCE III.