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Patient-reported symptoms at discharge and risk of complications after gynecologic surgery
  1. Xin Shelley Wang1,
  2. Pedro T Ramirez2,
  3. Qiuling Shi1,3,
  4. Mona Kamal1,
  5. Araceli Garcia-Gonzalez1,
  6. Maria D Iniesta2,
  7. Charles S Cleeland1 and
  8. Larissa A Meyer2
  1. 1Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  2. 2Department of Gynecologic Oncology and Reproductive Medicine, MD Anderson Cancer Center, Houston, Texas, USA
  3. 3Chongqing Medical University, Chongqing, China
  1. Correspondence to Professor Xin Shelley Wang, Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; xswang{at}mdanderson.org

Abstract

Objective Current gaps in knowledge limit clinicians from fully implementing patient-reported outcomes in routine post-operative care.

Methods This prospective study assessed symptoms via the gynecologic module of the MD Anderson Symptom Inventory (MDASI-PeriOp-GYN) in patients who underwent open laparotomy.

Results At discharge, patient-reported moderate to severe (≥4 on a 0–10 scale) abdominal bloating or abdominal cramping, combined with length of stay of ≥4 days, were found to be associated with a higher risk of 30-day post-operative grade II–IV complications by the Clavien-Dindo system (all p values <0.01). Also, length of stay of ≥4 days and moderate to severe urinary urgency at discharge were found to be associated with the need for re-admission (all p values <0.01).

Conclusion This study defined the clinically meaningful symptoms that related to the risk of developing important complications after discharge from major open gynecological surgery.

These findings support the integration of assessment of patient-reported outcomes into patient-centered post-operative care.

  • carcinoma
  • postoperative care
  • postoperative period

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @pedroramirezMD

  • Contributors Conceptualization: XSW, LAM, MK, CSC, PTR; Data curation: AG-G, MDI, MK; Formal analysis: QS; Funding acquisition: XSW, LAM; Investigation: All; Methodology: XSW, QS, CSC, PTR, MK, LAM; Project administration: All; Writing – original draft: XSW, MK, LAM; Writing – review and editing: All.

  • Funding We gratefully acknowledge NCI/NIH grant funding R01CA205146 to Dr Wang (“Improving Recovery After Major Cancer Surgery Using Patient-Reported Outcomes”) and NIH K07-CA201013 to Dr Meyer for support of this project.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.