Everlo, L. (Linda) (2014) Clinically relevant changes in patients with chronic gastrointestinal ischemia undergoing an intervention on splanchnic arteries. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
EverloL.pdf Restricted to Registered users only Download (1MB) |
Abstract
Background: In the evaluation of treatment for chronic gastrointestinal ischemia (CGI), there is a major lack of knowledge regarding patient-based outcomes, e.g. pain and quality of life. Although we know that treatment reduces symptoms, information about the magnitude of change in pain severity - and more importantly, to which extend these changes are relevant for the patients – is still poor. Moreover, data about the influence of treatment on health-related quality of life (HRQOL) is not available. Aim: The aim of this study was to i) determine the change of pain severity, ii) to evaluate the clinical relevance of this change by calculating the minimal clinically important difference (MCID) and iii) to determine the change in HRQOL, in patients receiving treatment for CGI. Methods: In patients undergoing an endovascular intervention for luminal stenosis in splanchnic arteries or an endoscopic release for celiac artery compression syndrome, patient-reported outcome measures regarding pain severity and HRQOL were assessed preoperatively and one month postoperatively, using the visual analog scale for pain intensity (VAS-PI) and the 36-item Short Form Health Survey (SF-36) for HRQOL. Three established anchors were used to calculate the MCID in pain; i) patient-reported pain relief; ii) the use of analgesics and iii) patient-reported treatment satisfaction. Results: Fifteen patients completed the assessments. The average change in pain after treatment was found to be a significant decrease from 70 mm to 2 mm on the VAS-PI. Due to a too high treatment satisfaction it was not possible to calculate the MCID for pain relief. The instead calculated substantial clinical benefit (SCB) was found to be 64 mm or 98 % on the VAS-PI. Significant improvements were found for the dimensions Bodily Pain and Social Functioning as well in the Mental Component Summary score of the SF-36. Conclusion: This pilot study shows a major statistically and clinical significant pain reduction for patients receiving treatment for CGI. Moreover, it provides data to improve our understanding of pain ratings of these patients - although the MCID for pain relief could not be defined. Further, this study suggests that CGI treatment has beneficial effects on HRQOL.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Kolkman, Prof. Dr. J.J. MDL-arts |
| Supervisor name: | Mensink, Dr. P.B. MDL-arts and Medisch Spetrum Twente, Enschede |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2422 |
Actions (login required)
 |
View Item |