Effects on delayed surgery in inflammatory bowel disease – health related quality of life

Abstract Introduction Timing in surgery for inflammatory bowel disease (IBD) is important considering risk of complications, such as fistulizing disease, severe proctitis and high stoma output. This study aimed to address Health-Related Quality of Life (HRQoL) when waiting for surgery. Method This study was a cross-sectional register-based study combined with individual-level collected data on the EQ-5D-5L questionnaire assessing the effects of delayed elective surgery on HRQoL amongst patients with IBD. Patients either waiting for, or who had undergone surgery at Sahlgrenska University Hospital during 2017-2023 with an IBD-diagnosis were identified. Result Of the 214 patients included in the study (33.64% women, mean age 44.3+16.9 years), 60% of the patients had undergone surgery, while the remainder were still awaiting surgery. The mean EQ VAS for the entire sample was 64.9, with the lowest scores observed when waiting for surgery for more than one year, compared to previous age matched population norms in Sweden, with a mean score of 87.0. The mean EQ-5D-5L index for patients waiting less than 3 months differed from those who waited 12-24 months (p=0.017) and >24months (p=0.012) respectively. Likewise, the mean EQ-5D index for those who waited 3-6 months differed from those waiting >12-24 months (p=0.036) and >24 months (p=0.032), using the Swedish value set. Discussion There were significant differences in HRQoL between patients who had undergone surgery within the Swedish health care guarantee (<3 months) and those who had been waiting for at least one year. This indicates that waiting time for surgery may impact HRQoL among patients with IBD.