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Results for “Functional outcome”

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PubMed1999

Study of the relationship between premorbid urinary incontinence and stroke functional outcome.

OBJECTIVE: To examine functional outcome in stroke patients with premorbid incontinence of urine. METHOD: Comparative study in stroke patients between premorbidly incontinent and continent groups. Both groups were subjected to structured interview, clinical examination and functional assessment at one week post stroke. Functional assessment was repeated six months later. SUBJECTS: Eighty-six patients with first-time stroke younger than 80 years of age admitted to hospital, were divided into two groups according to their continence status. OUTCOME MEASURE: The 20-point Barthel Index. SETTING: Medical wards at North Staffordshire Teaching Hospitals. RESULTS: Of 86 stroke patients (46 continent and 40 premorbidly incontinent), 19 died before six-month assessment, of whom 15 (79%) were premorbidly incontinent. Premorbid incontinence was the most significant variable predicting poor functional outcome (Barthel Index score <15) at six months, with a sensitivity of 82.6% and specificity of 86.4% and with age-corrected p-value of <0.001. CONCLUSIONS: This study shows a significant relationship between premorbid incontinence and functional outcome at six months. However, other causes that could have contributed to the premorbid incontinence were not excluded. This point needs to be considered in future studies, which should also examine whether premorbid incontinence per se reflects an underlying predisposition for stroke.

Aged↗

PubMed1997

Does modification of the Innsbruck and the Glasgow Coma Scales improve their ability to predict functional outcome?

BACKGROUND: The accurate prediction of functional outcome requires the development of multivariate models. To enhance their contribution to such models, the predictive power of each component must be optimized. OBJECTIVES: To improve the predictive power of coma scales as the first step in building more sophisticated multivariate models to predict specific levels of functional outcome. DESIGN: Prospective descriptive study. SETTING: Neurology and neurosurgery intensive care unit (NNICU) in a tertiary care academic center. PATIENTS: Eighty-four patients with acute traumatic brain injury, intracerebral hemorrhage, subarachnoid hemorrhage, or ischemic stroke. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The Glasgow Coma Scale (GCS) and Innsbruck Coma Scale (ICS) were administered within 24 hours of admission to the NNICU and then at 48-hour intervals until discharge of the patient from the NNICU. The assessments were performed by 3 occupational therapy graduate students working under the supervision of the medical director of the NNICU. The functional outcome at 3 months after discharge from the hospital was assessed by telephone by the same nurse using the following categories: (1) dead, (2) receiving nursing home or custodial care, (3) home with help, or (4) independent. Cronbach's alpha estimates of reliability for each scale were computed using all scores obtained during the study. The analyses indicated that the verbal response item of the GCS and the oral automatisms item of the ICS were less reliable in this patient population. The scales were modified by deleting those items, and predictive validity for the original and modified scales was computed using a discriminant function of the admission scores. RESULTS: Before modification, both scales were best at predicting independence (GCS and ICS, 71% correct) and mortality (GCS, 60% correct; ICS, 56% correct). The modifications produced a modest improvement in the ability of both scales to better predict levels of outcome (modified GCS: home with help, 33% correct, independent, 71% correct; modified ICS: home with help, 0% correct, independent, 74% correct). CONCLUSIONS: By deleting items with low reliability from the ICS and the GCS we achieved improved reliability and predictive validity. The improvement in predictive power, however, was inadequate to accurately predict functional outcome. Combining clinical scales with other demographic, physiological, functional, and radiographic data will be needed to achieve useful predictions of functional outcome.

Adult↗

PubMed2001

Functional outcomes and quality of life in patients with brain tumours: a review of the literature.

OBJECTIVE: To review the literature with respect to functional outcomes and quality of life as it pertains to individuals with brain tumours. MAIN OUTCOMES: Most functional outcome papers have focused on acute inpatient rehabilitation. In general, patients with brain tumours have comparable rates of functional gains as other models of neurologic disability. Tumour type and concomitant treatment do not impact functional outcome. Functional independence may predict survivability in certain populations. Numerous instruments are used to measure the multiple facets of quality of life. Depression, anger and fatigue can impact both physical and psychological aspects of quality of life. The physical and functional aspects can vary depending on the tumour type. Treatment regimens can negatively impact quality of life. CONCLUSION: Brain tumour patients experience changes in function and quality of life during their disease course. Rehabilitation services may offer a unique opportunity to influence both functional outcome and more closely assess quality of life in these individuals.

Brain Neoplasms↗

PubMed2004

Functional outcome in patients with critical illness polyneuropathy.

PURPOSE: To evaluate the functional outcome of intensive care patients with critical illness polyneuropathy (CIP), 6 and 12 months after the onset. METHODS DESIGN: A prospective observational cohort study and a cross-sectional study. SETTING: University hospital in the Netherlands. PATIENTS: Eight consecutive intensive care patients with CIP for the prospective study and eight patients diagnosed with CIP in the past 6 months for the cross-sectional study. MAIN OUTCOME MEASURES: Functional outcome regarding body functions and structure, activities, participation and perceived quality of life. RESULTS: Nine patients (56%) died within one year. Functional outcome, participation and subjective health status in survivors varied widely at 6 and 12 months. After 12 months, physical functioning was improved in all patients. However activities related to mobility outdoors, autonomy, participation and quality of life were restricted in most patients. CONCLUSIONS: The majority of survivors have persistent functional disabilities in activities, reduced quality of life and restrictions in autonomy and participation one year after the onset of CIP. Prolonged rehabilitation treatment is necessary for an increasing number of intensive care patients who develop CIP, in order to reduce handicaps and achieve optimal autonomy and social participation.

Adult↗

PubMed2006

Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes.

AIM: To evaluate the functional outcomes of patients who underwent total or nearly total glossectomy for advanced tongue or base of tongue cancer. MATERIAL AND METHODS: We used the radial forearm free flap (RFFF), anterior lateral thigh flap (ALTF) or fibular osteocutaneous flap (FOCF) to reconstruct the oral defect after radical resection in 39 patients undergoing total or nearly total glossectomy with laryngeal preservation. RESULTS: Good functional outcomes, measured by independent feeding, speech and swallowing were achieved in 35, 36 and 35 patients, respectively. The cumulative 4-year survival rates were 63.8% for tongue cancer and 42.9% for base of tongue cancer. CONCLUSION: Reconstruction with free flaps is a feasible method to restore the functional outcomes in speech and deglutition among patients who undergo total or nearly total glossectomy with laryngeal preservation.

Adult↗

PubMed2004

Functional outcomes and mortality vary among different types of hip fractures: a function of patient characteristics.

A review of prospectively collected data was done to compare functional outcomes and mortality among patients with different hip fracture types. Five hundred thirty-seven elderly patients who sustained a hip fracture were followed up prospectively. Orthopaedists blinded to treatment and outcome radiographically classified the fractures as either: (1) nondisplaced or impacted femoral neck; (2) displaced femoral neck; (3) stable intertrochanteric; or (4) unstable intertrochanteric fracture. Functional independence measure scores were calculated for preinjury function and at 2- and 6- month follow-ups. Comorbidities, operative details, postoperative complications, and deaths were recorded. Six-month mortality was lowest for patients with nondisplaced femoral neck fractures (5.7%) and highest for patients with displaced femoral neck fractures (15.8%), but multivariate analysis only identified preinjury function as an independent predictor of mortality. All preinjury and followup functional independence measure scores were greatest for patients with nondisplaced femoral neck fractures and least for patients with unstable intertrochanteric fractures. However, multivariate analysis identified only patient age and preinjury functional independence measure scores as independent predictors of functional outcome. These data show differences in mortality and functional outcomes among fracture types that can be attributed to differences in functional status before injury.

Activities of Daily Living↗

PubMed2001

Determinants of functional outcome and healthcare costs in bipolar disorder: a high-intensity follow-up study.

BACKGROUND: Review of published studies reveals few data regarding determinants of the poor functional outcome and high healthcare costs that are characteristic of bipolar disorder. In order to identify potential mechanisms, critical to designing optimal treatment strategies, this longitudinal study investigated (a) the degree to which disease outcome is correlated with functional outcome and direct treatment costs, and (b) whether similar demographic or clinical characteristics predict disease and functional outcome and healthcare costs. METHODS: Disease and functional outcome were assessed in bimonthly structured interviews over 48 weeks in 43 outpatient veterans with bipolar disorder. Direct mental health treatment costs from the VA perspective were determined from the VA database and patient interview. Regression analysis was used to determine association among the three outcome domains, and to identify clinical or demographic variables that predicted each of the three domains. RESULTS: Functional outcome was correlated with depressive, but not manic, symptoms during follow-up. Costs were not correlated with any measure of disease or functional outcome. Several demographic, but not clinical, characteristics predicted functional outcome. In contrast, several clinical, but not demographic, characteristics predicted symptom status. No predictors were associated with direct treatment costs. LIMITATIONS: Subjects were predominantly male veterans of relatively homogeneous social class, followed prospectively for approximately one year in a clinic designed specifically to minimize barriers to care. CONCLUSIONS: Data from this and prior studies indicate that ongoing depressive symptoms are strongly associated with functional outcome, although substantial variance remains unexplained. Optimal models to explain functional outcome and healthcare costs will need to address factors besides simply disease severity and chronicity. The authors present a heuristic paradigm for understanding both the research and therapeutic aspects of these findings.

Activities of Daily Living↗

PubMed1998

Factors influencing the functional outcome of patients with acute epidural hematomas: analysis of 200 patients undergoing surgery.

OBJECTIVE: To determine the prognostic factors of the functional outcome of patients surgically treated for acute epidural hematomas. METHODS: Two hundred patients who consecutively underwent neurosurgery for acute epidural hematomas over the past 9-year period were studied. Clinical characteristics, radiologic findings, and the time intervals with regard to treatment course were investigated to determine the interactions between all these factors and functional outcome. RESULTS: Functional outcome showed a significant correlation with preoperative consciousness state, Glasgow Coma Scale score, pupillary sizes, and motor posturing (chi2 test, p < 0.05). Functional outcome correlated with the period of brain herniation, the length of time of the operation, as well as the period of hospitalization (chi2 test, p < 0.05), but not with the length of time of craniotomy decompression relative to the length of time from the injury until admission. The radiologic findings of the associated brain injury, the size and the density of the clot, the degree of the brain shift, and the obliteration of the basal cisterns significantly correlated with functional outcome (chi2 test, p < 0.05), whereas no significance was attributable to skull fracture. Multivariate analysis indicated that the following four factors independently correlated with functional outcome: (1) associated brain injury, (2) best motor response, (3) hematoma volume, and (4) period of hospitalization (chi2 test, p < 0.05). A combination of the four factors led to the prediction of the functional outcome with 91% accuracy (1.5 % falsely pessimistic predictions and 7.5 % falsely optimistic prediction) and 82.1% at over 90% confidence level. These four parameters correlated significantly with preoperative neurologic deterioration (chi2 test, p < 0.05). CONCLUSION: This study identifies the risk factors involved in the functional outcome of patients who underwent surgical treatment for acute epidural hematomas. Our results indicate that associated brain injury plus best motor response are the optimal set of two prognostic indicants, with 87% correct predictions and 70.1% at over a 90% confidence level. Prevention of in-hospital neurologic deterioration would improve the patients' functional outcome with a resultant unfavorable recovery rate ranging from 11.5% to 17%.

Acute Disease↗

PubMed1996

Rehabilitative functional outcome of patients with neoplastic spinal cord compressions.

OBJECTIVE: To examine functional outcome and descriptive data of individuals with neoplastic spinal cord compression admitted to a rehabilitation unit. DESIGN: A 5-year review of consecutive patients admitted to a spinal cord injury rehabilitation unit with a diagnosis of neoplastic spinal cord compression. SETTING: A tertiary university medical center. PATIENTS: Thirty-two consecutive patients with neoplastic spinal cord compression who met standard rehabilitation admission criteria and had a prognosis of no less than 3 months' survival. MAIN OUTCOME MEASURES: Functional data, including length of stay, functional outcomes (utilizing Functional Independent Measurement scores in mobility and self-care), bladder management, and disposition. RESULTS: Lung (28%) and prostate (17%) were the most common tumor types, and upper thoracic (40%) was the most common level of spinal cord involvement. Functional Independent Measure improvements were found in all areas, with significant improvements (paired t test, p < .005) noted in the areas of upper and lower extremity dressing, grooming, toilet and tub transfers, wheelchair use and transfers, ambulation, and stair climbing. Average length of rehabilitation stay was 27 days, and 84% of the patients were discharged to home. Seventy-five percent of the 20 responders to a follow-up survey had maintained or improved their discharge functional abilities at 3 months after discharge. CONCLUSIONS: These data suggest that in individuals with spinal cord compression caused by neoplastic invasion, functional improvements in mobility and self-care can be achieved and maintained for at least 3 months after discharge.

Activities of Daily Living↗

PubMedDate not supplied

Prosthetic intervention in the era of microvascular reconstruction of the mandible--a retrospective analysis of functional outcome.

PURPOSE: The purpose of this retrospective study was to compare the functional outcomes of patients who had mandibular resection and reconstruction with and without prosthetic intervention, and to identify predictive factors that may have an impact on functional outcomes. MATERIALS AND METHODS: Two hundred twenty head and neck cancer patients who had undergone mandibular resection and reconstruction with at least 6 months of postoperative convalescence formed the basis of this retrospective review. Patients who did not receive prosthetic intervention formed group I (n = 142); those who received prosthetic intervention formed group II (n = 78). Functional outcomes were measured using four individual assessments (nutritional status, swallowing, masticatory performance, and speech) and one that combined the information from these assessments, the global measure of functional outcome (GMFO). Statistical analyses were used to compare the baseline characteristics and functional outcome between groups I and II and to analyze independent predictors for GMFO. RESULTS: Of the 220 patients reviewed, 78 (35%) had prosthetic intervention; group II patients had better individual functional outcome measures and GMFO. Use of a prosthesis remained associated with GMFO after controlling for other significant predictors; other independent predictors were xerostomia, number of remaining mandibular teeth, number of tooth-to-tooth contacts, type of reconstruction, flap interference, and tongue defect. Patients who had fewer mandibular teeth and received a smaller prosthesis had better overall outcome than patients who received a larger prosthesis. CONCLUSION: Patients who had prosthetic intervention after mandibular reconstruction had significantly better functional outcomes than patients who did not receive prosthetic intervention, even after adjusting for confounding variables.

Adult↗

PubMed2005

Functional outcome scales in traumatic brain injury: a comparison of the Glasgow Outcome Scale (Extended) and the Functional Status Examination.

Clinical trials aimed at developing therapies for traumatic brain injury (TBI) require outcome measures that are reliable, validated, and easily administered. The most widely used of these measures, the Glasgow Outcome Scale (GOS) and the GOS-Extended (GOS-E), have been criticized as suffering from ceiling effects. In an attempt to develop a more useful and dynamic outcome measure, the Functional Status Examination (FSE) was developed, which grades outcome across 10 functional domains. The FSE has been demonstrated to be reliable and sensitive in monitoring recovery after TBI. This manuscript compares FSE with GOS-E in a cohort of patients with a wide range of injury severities. 177 individuals who survived at least 6 months after TBI were studied. The FSE and GOS-E were administered 6-12 months after injury. FSE and GOS-E scores correlated well with each other. FSE scores were distributed throughout the range, indicating that ceiling and floor effects were not present. Physiologic measures of injury severity (Glasgow Coma Score [GCS]) did not correlate with anatomic measures (Abbreviated Injury Scale [AIS] and Injury Severity Score [ISS]). GCS correlated weakly with both outcome measures, but AIS/ISS did not. We conclude that FSE and GOS-E are reliable outcome measures for TBI survivors, and FSE may offer some advantages over GOS-E due its ability to provide a more detailed description of deficits. The majority of the variance in outcome is not accounted for by currently available measures of injury severity.

Abbreviated Injury Scale↗

PubMed2003

The correlation between quality of life and functional outcome in ulcerative colitis patients after proctocolectomy ileal pouch anal anastomosis.

OBJECTIVE: The aim of this study was to evaluate functional outcome and quality of life (QOL) in patients undergoing proctocolectomy ileal pouch anal anastomosis (IPAA), to assess the correlation between functional outcome and QOL, and to identify factors influencing functional outcome and QOL in these patients. BACKGROUND: IPAA is now considered the procedure of choice for ulcerative colitis. Functional outcome and QOL are important factors in evaluating operative outcome. METHODS: All patients with UC who had undergone IPAA at our institute during the period 1990-2001 were included. QOL and functional outcome were evaluated by mailed questionnaires. QOL was scored using the Short Form 36 (SF-36). Global Assessment of Function Scale was used to evaluate functional outcome. RESULTS: Data were obtained in 77 of 99 patients (78%), with the median age of 38 years. Median follow up time was 4.25 years. The QOL in patients after pelvic pouch procedure was excellent, with scores equal to published norms for the Israeli general population in most scales. Functional outcome and QOL scores correlated strongly (r > 0.5; P < 0.0001) in all dimensions. Older age was associated with lower scores in both functional outcome and QOL scales (P < 0.0001). CONCLUSIONS: This study demonstrates a strong association between functional outcome and QOL in patients after IPAA. These patients, however, have a QOL that is comparable with the general population. Age at time of surgery strongly influences both functional outcome and QOL. This finding has to be taken into consideration in pre-operative counseling.

Adolescent↗

PubMed1996

Functional outcome of lower-limb amputees: a prospective descriptive study in a general hospital.

This paper describes functional outcome of a population of lower limb amputees five months after amputation compared with their preoperative functional abilities and studies the relationship between potential determinants and functional outcome. Twenty out of 26 patients who underwent a lower limb amputation between December 1993 and August 1994 in a general hospital in Amsterdam were included in the study. Their functional abilities before amputation were retrospectively assessed using an ICIDH (International Classification of Impairments, Disabilities and Handicaps)-based questionnaire. Functional outcome was assessed after amputation of the lower limb using ICIDH-based and SIP (Sickness Impact Profile)-questionnaires. The mean SIP scores were high (referring to a low functional outcome). Disabilities were spread over the five disability fields of the ICIDH. The functional outcome of the diabetic versus the non-diabetic group was lower on the physical, activities of daily living (ADL), psychological and communicative categories of the ICIDH. In most patients, functional outcome decreased. The diabetic patients compared to the non-diabetics showed more diversity in functional outcome, compared with their preoperative functional abilities. Increasing age is significantly associated with a low functional outcome on the SIP scores. Diabetes is age-related for this sample. Co-morbidity and motivation are strongly age-related for this sample. It was concluded that lower-limb amputees appear quite disabled in all disability categories of the ICIDH and as assessed by the SIP scores. In most patients, functional abilities decrease after lower limb amputation. Age seems to be a significant factor related to functional outcome.

Activities of Daily Living↗

PubMed1999

Functional outcome in extremity soft tissue sarcoma.

The studies reporting functional outcome for patients undergoing limb preservation surgery for extremity soft tissue sarcoma (STS) have evaluated mainly impairments, that is, deficits at an anatomic structure level, such as joint range of motion and strength. Disability, activities of daily living, self-care, and mobility have been less frequently evaluated. Review of the literature suggests that approximately 50% of patients treated for STS have significant impairments, whereas the frequency of disability is less. Synthesis of the results is difficult because of the heterogeneity of patient samples, treatment, and the outcomes used to evaluate function. Future studies require the use of standardized definitions and reliable and valid functional outcome measures. Improved patient outcomes can be achieved only by understanding the determinants of these outcomes and by introducing interventions to improve patient functional outcome.

Activities of Daily Living↗

PubMedDate not supplied

Predicting follow-up functional outcomes in outpatient rehabilitation.

Functional outcomes at an average of six months after outpatient rehabilitation were investigated in a pilot study with a sample of 42 patients receiving physical therapy for low back, neck, and other musculoskeletal problems. Logistic regression analyses were used to study variables related to the achievement of a predetermined level of physical functioning or to whether improvement occurred from initial to follow-up assessment. Scales used in the analyses were obtained from two measures of functioning, the Medical Outcomes Trust Short Form 36 (SF-36) and the Medical Rehabilitation Follow Along (MRFA instrument). Demographic and program characteristic variables obtained from clinic records were also included in the analyses. The independent variables entered into two groups of regression equations included age, gender, presenting problem, workers' compensation coverage, functioning at initial assessment, number of visits, length of program, and intensity of program. For the SF-36, the General Health scale and presenting problem predicted above or below a level greater than one standard deviation less than the mean on the Physical Functioning scale at follow-up. The combination of the Role Physical and Role Emotional scales predicted follow-up level on the Physical Component Summary (PCS) scale. The interaction of age and intensity of treatment was predictive for both the Physical Functioning and PCS scales. For predicting improvement or no improvement using the SF-36 scales, General Health and the interaction between age and intensity were predictive of change on the Physical Functioning scale, whereas age and the interaction between age and number of visits were predictive of change on the PCS scale. For the MRFA instrument, the interaction between age and the intensity of treatment was predictive for both a predetermined level of physical functioning and amount of improvement in physical functioning at follow-up. An intensity rating of pain and a measure of affective distress at initial assessment both improved the identification of patients at risk for not reaching a given level of functioning, whereas treatment intensity improved the identification of those patients at risk for not showing improvement at follow-up. Length of time between the end of outpatient therapy and follow-up assessment was generally not related to follow-up physical functioning. Interpretation and implications of these findings, as well as applications of this analytic approach to outcomes assessment, are discussed.

Activities of Daily Living↗

PubMed1995

Diode laser treatment for retinopathy of prematurity: structural and functional outcome.

AIMS: The anatomical and functional outcome of 13 babies with retinopathy of prematurity (ROP) treated with binocular indirect ophthalmoscope diode laser photocoagulation was assessed. METHODS: Thirteen babies (25 eyes) at median postmenstrual age (PMA) 25.5 weeks and median birth weight 725 g were treated with binocular indirect ophthalmoscope (BIO) diode laser photocoagulation when threshold retinopathy of prematurity (ROP) was detected at median PMA 35 weeks. Retinopathy was more severe in the nasal retina in 15 eyes. The median severity of retinopathy was 6 clock hours grade 3 disease. All babies were treated under general anaesthetic with no significant ocular or systemic complications during treatment. The median number of burns was 1200. RESULTS: Resolution of active retinopathy occurred 1-2 weeks following treatment in all but one baby. All eyes had favourable anatomical and functional outcome as defined by the Cryo-ROP study group at a median age of 19.5 months of follow up. CONCLUSION: BIO diode laser treatment is as effective as cryotherapy with less morbidity.

Female↗

PubMed2002

Effects on functional outcome after IORT-containing multimodality treatment for locally advanced primary and locally recurrent rectal cancer.

PURPOSE: In the treatment of patients with locally advanced primary or locally recurrent rectal cancer, much attention is focused on the oncologic outcome. Little is known about the functional outcome. In this study, the functional outcome after a multimodality treatment for locally advanced primary and locally recurrent rectal cancer is analyzed. METHODS AND MATERIALS: Between 1994 and 1999, 55 patients with locally advanced primary and 66 patients with locally recurrent rectal cancer were treated with high-dose preoperative external beam irradiation, followed by extended surgery and intraoperative radiotherapy. To assess long-term functional outcome, all patients still alive (n = 97) were asked to complete a questionnaire regarding ongoing morbidity, as well as functional and social impairment. Seventy-six of the 79 patients (96%) returned the questionnaire. The median follow-up was 14 months (range: 4-60 months). RESULTS: The questionnaire revealed fatigue in 44%, perineal pain in 42%, radiating pain in the leg(s) in 21%, walking difficulties in 36%, and voiding dysfunction in 42% of the patients as symptoms of ongoing morbidity. Functional impairment consisted of requiring help with basic activities in 15% and sexual inactivity in 56% of the respondents. Social handicap was demonstrated by loss of former lifestyle in 44% and loss of professional occupation in 40% of patients. CONCLUSIONS: As a result of multimodality treatment, the majority of these patients have to deal with long-term physical morbidity, the need for help with daily care, and considerable social impairment. These consequences must be weighed against the chance of cure if the patient is treated and the disability eventually caused by uncontrolled tumor progression if the patient is not treated. These potential drawbacks should be discussed with the patient preoperatively and taken into account when designing a treatment strategy.

Adult↗

PubMed2006

Functional outcome and quality of life in anorectal malformations.

BACKGROUND/PURPOSE: The aim of this study was to assess the early functional outcome and quality of life (QOL) in children with anorectal malformations. METHODS: Children treated for anorectal malformations (ARMs) from 1994 to 2000 were evaluated if 4 years or older. Primary outcome measures were bowel function score, assessed by functional outcome questionnaire, and QOL using the Pediatric Quality of Life Inventory (PedsQL 4). The secondary outcome measure was age at potty training. Twenty healthy children were used as controls for functional outcome and age at potty training. Data are reported as mean (SD) unless otherwise stated. RESULTS: Eighty children were evaluated during the study period. The mean age at follow-up was 82 months (18.7). The response rate was 76.3% (58/76) for bowel function and 77.5% (62/80) for QOL questionnaires. Functional outcome score (maximum 20) decreased significantly with increasing severity of the ARM (male perineal fistula, 16 [3]; female perineal fistula, 15 [3]; rectourethral fistula, 12 [4]; vestibular fistula, 13 [3.5]; bladder neck fistula, 6 [2]; analysis of variance, P = .001). However, there was no difference in QOL between patients with ARM and controls. There was no correlation between age and either bowel function score (Pearson r2 = 0.06) or QOL (Pearson r(2) = 0.12). Affected children took significantly longer to achieve potty training for bladder (35 [13.8] months vs 26 [8.7] months for controls [t test, P = .005]) and bowels (38 [16] months vs 25 [7] months [t test, P = .001]). CONCLUSION: Children with ARMs have significantly worse bowel function than their peers, depending on the type of lesion. Despite these findings, QOL was not significantly impaired. No correlation was demonstrated between age and either functional outcome or QOL.

Abnormalities, Multiple↗