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Patient-Reported Trajectories After Intestinal Stoma Formation: A Prospective Longitudinal Study of Stoma-Related Outcomes and Global Quality of Life

Year: 2026

Type: article

Abstract: Background: Recovery after intestinal stoma formation involves practical, psychological, social, and functional changes that may not evolve in parallel with patients’ overall perception of quality of life. This study examined patient-reported trajectories during the first six postoperative months and explored whether multidimensional stoma-related outcomes followed the same pattern as directly reported global quality of life. Methods: This prospective single-centre observational study included patients with complete assessments at approximately 2 weeks, 1 month, 3 months, and 6 months after ileostomy or colostomy formation. Patient responses were collected at each follow-up and subsequently manually transcribed into an electronic study database. The primary exploratory outcome was a corrected 30-component stoma-related patient-reported composite index (range 0–30; higher values more favourable) derived from an adapted, non-validated questionnaire. A direct 0–10 global quality-of-life item, which also contributed one component to the composite, was analysed separately. Longitudinal change was assessed using Friedman tests with Bonferroni-adjusted Wilcoxon signed-rank comparisons. Post hoc robustness analyses recomputed the composite after excluding the global quality-of-life component and after additionally excluding the sexual-activity components. Results: Our study included 23 patients. The median composite index increased from 9.4 (IQR 7.2–13.6) at 2 weeks to 10.9 (8.7–13.6) at 1 month and 12.2 (9.3–15.3) at 3 months and was 11.8 (9.3–17.2) at 6 months (Friedman chi-square(3) = 19.08, p < 0.001; Kendall’s W = 0.276). Bonferroni-adjusted comparisons were significant for 2 weeks versus 3 months (p = 0.037), 2 weeks versus 6 months (p = 0.016), and 1 month versus 6 months (p = 0.045). Median global quality-of-life ratings were 5, 6, 6, and 5, respectively, with no significant longitudinal change (p = 0.753). Excluding the global quality-of-life component from the composite produced a similar overall result (Friedman chi-square(3) = 19.38, p < 0.001). Conclusions: The exploratory composite showed statistically significant longitudinal change during the first six postoperative months, whereas directly reported global quality of life did not show a parallel change. Because the composite is non-validated and no threshold for clinically meaningful change has been established, these findings should not be interpreted as demonstrating clinically meaningful improvement in adaptation or quality of life. Rather, they suggest that several stoma-related patient-reported dimensions may change over time differently from global quality of life. These findings are exploratory and require confirmation in larger cohorts using validated patient-reported outcome measures.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15218654