BJUI compass · 2026
The impact of high-grade complications on quality of life and psychosocial distress in the early period after radical cystectomy.
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Müller Guido, Bahlburg Henning, Götte Mayumi, Butea-Bocu Marius Cristian, Roghmann Florian, Noldus Joachim
Аннотация
OBJECTIVES: This study aims to investigate the impact of high-grade complications (i.e., Clavien-Dindo Classification [CDC] Grade ≥III) on quality of life (QoL) and psychosocial distress (PD) in the early period after radical cystectomy (RC) and urinary diversion.
PATIENTS AND METHODS: The study relied on prospectively collected data of patients undergoing 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (ileal conduit [IC] or ileal neobladder [INB]) between 04/2018 and 12/2019. Patients were surveyed on QoL (EORTC QLQ-C30) and PD (QSC-R10) by validated questionnaires at the beginning and the end of IR. Information about complications before the start of IR was taken from the hospital discharge letters and patient interview.
RESULTS: Overall, 842 patients were enrolled. High-grade complications occurred in 25.5% of patients. Men (27.4% vs. 17.6%, p = 0.011) and patients with an INB (28.9% vs. 22.6%, p = 0.037) were significantly more susceptible to high-grade complications. At the beginning of IR, health-related QoL (HRQoL), role and social functioning were significantly lower in patients with a high-grade complication. Both HRQoL and the proportion of patients with high PD improved significantly during IR (p < 0.001, respectively). A multivariable linear regression analysis identified high-grade complications to significantly impact HRQoL (p = 0.013). Meanwhile, age (p = 0.001), INB (p = 0.019) and high-grade complications (p = 0.01) significantly contributed to PD.
CONCLUSION: High-grade complications after RC and urinary diversion significantly impair short-term QoL and PD, warranting constant physical and psychosocial monitoring.
PATIENTS AND METHODS: The study relied on prospectively collected data of patients undergoing 3 weeks of inpatient rehabilitation (IR) after RC and urinary diversion (ileal conduit [IC] or ileal neobladder [INB]) between 04/2018 and 12/2019. Patients were surveyed on QoL (EORTC QLQ-C30) and PD (QSC-R10) by validated questionnaires at the beginning and the end of IR. Information about complications before the start of IR was taken from the hospital discharge letters and patient interview.
RESULTS: Overall, 842 patients were enrolled. High-grade complications occurred in 25.5% of patients. Men (27.4% vs. 17.6%, p = 0.011) and patients with an INB (28.9% vs. 22.6%, p = 0.037) were significantly more susceptible to high-grade complications. At the beginning of IR, health-related QoL (HRQoL), role and social functioning were significantly lower in patients with a high-grade complication. Both HRQoL and the proportion of patients with high PD improved significantly during IR (p < 0.001, respectively). A multivariable linear regression analysis identified high-grade complications to significantly impact HRQoL (p = 0.013). Meanwhile, age (p = 0.001), INB (p = 0.019) and high-grade complications (p = 0.01) significantly contributed to PD.
CONCLUSION: High-grade complications after RC and urinary diversion significantly impair short-term QoL and PD, warranting constant physical and psychosocial monitoring.