The influence of clinical and patient-reported outcomes on post-surgery satisfaction in cholecystectomy patients.

K. Mclean, Sheng Zhou, Stephen O'Neill, K. Boyce, C JONES, Stephen Wigmore, Ewen Harrison

Research output: Contribution to journalArticlepeer-review


Background: Patient reported outcomes (PROMs) and post-operative satisfaction have become a growing focus of surgical outcome evaluation and are considered key components of the movement towards patient-centred care. The aim was to compare the association of traditional clinical outcome measures and PROMs with post-surgery satisfaction in cholecystectomy patients.Methods: Patients who had undergone elective or emergency cholecystectomy for gallstone disease were sent validated PROM questionnaires and telephone follow-up was performed in all cases. Categorical data were compared with the chi-squared and Fisher’s exact tests. Satisfaction was investigated using a “top-box” approach and multivariable logistic regression was performed for factors significantly (p<0.05) associated with satisfaction in univariable analyses. 
Results: 234 patients underwent cholecystectomy between 1st March and 1st May 2014 and 147 patients (63%) completed the questionnaire. 104/147 (71%) reported being “very satisfied” with their surgical outcome. In univariable analyses, satisfaction showed significant association with an absence of hospital-recorded 30-day complications (OR=4.11, 95% CI 1.29-13.84), but not re-attendance, readmission, or length of stay. In a multiple regression analysis, no traditional clinical outcome measures were associated with satisfaction. By contrast self-perceived health (OR=4.04, 95% CI 1.44-11.86), the absence of patient-reported wound pain (OR=6.11, 95% CI 1.83-21.74), and a return to normal leisure activities (OR=11.14, 95% CI 2.61-55.26) were associated with satisfaction. 
 Conclusions: PROMs are the major determinants of patient satisfaction following cholecystectomy. When assessing outcomes following cholecystectomy, the measurement of clinical outcomes alone is inadequate and should be supplemented by the use of PROMs.
Original languageEnglish
JournalWorld Journal of Surgery
Early online date9 Mar 2017
Publication statusE-pub ahead of print - 9 Mar 2017


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