Development of a patient-reported outcome tool for assessing symptom burden during perioperative care in liver surgery: The MDASI-PeriOp-Hep.
Xin Shelley Wang, Qiuling Shi, Loretta A Williams and 8 others
PMID 33964632WHAT IT FOUND
A short symptom checklist for liver surgery patients captured fatigue, bloating, cramping, constipation and incision tightness, and severe symptoms improved after discharge.
It is quick and acceptable, but not yet tested for changing care.
Key findings
01The final MDASI-PeriOp-Hep added 5 liver-surgery symptom items: abdominal bloating, tightness, or fullness; abdominal cramping; muscle weakness, instability, or vertigo; constipation; and incisional tightness.
02In 150 patients, the symptom severity and interference scales were consistent, and 95% completed the tool with no missing items.
03During hospitalization, 30% of patients rated 4 to 6 symptoms as severe and 18% rated 8 to 12 as severe; after discharge, 14% reported 3 to 9 as severe.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in English-speaking patients at a GI Surgical Oncology Clinic, so results may not apply to other languages or settings. It was a convenience sample and a cross-sectional validation, not a randomized trial of treatment. Sensitivity of the tool over time still needs a longitudinal study with the same patients. The study did not compare the tool with the liver-specific EORTC QLQ-HCC18 or QLQ-LMC21 modules, so it cannot conclude that the tool is more sensitive than those versions. The study did not test whether using the tool changes patient care, recovery, or return to cancer therapy.
Declared interests
The MDASI and its derivatives are copyrighted and licensed by The University of Texas MD Anderson Cancer Center and Charles S. Cleeland. Authors Xin Shelley Wang and Charles S. Cleeland have a financial interest in the MDASI and its derivative versions.
The easy way to misread this
Do not read this as evidence that using the MDASI-PeriOp-Hep improves liver surgery recovery. The study validated a symptom questionnaire in 150 patients, but it did not test whether using the tool changes care or outcomes, and sensitivity over time still needs a longitudinal study.