The impact of parastomal hernia on quality of life using data from the CIPHER prospective cohort study

Joel Glynn (), William Hollingworth, Jessica Harris, Syed Mohiuddin, Lucy Ellis, Barnaby C. Reeves and Neil Smart
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Joel Glynn: University of Bristol
William Hollingworth: University of Bristol
Jessica Harris: University of Bristol
Syed Mohiuddin: National Institute for Health and Care Excellence (NICE)
Lucy Ellis: University of Bristol
Barnaby C. Reeves: University of Bristol
Neil Smart: Royal Devon University Healthcare NHS Foundation Trust

The European Journal of Health Economics, 2025, vol. 26, issue 7, No 7, 1209-1218

Abstract: Abstract Objectives Despite being a common side effect of stoma surgery, little is known about the health-related quality-of-life (HRQoL) impact of parastomal hernia (PSH). We studied the association between HRQoL and self-reported PSH using data from the large CIPHER prospective cohort study of patients living with a stoma. Methods Over 12 months, HRQoL was captured at up to four time points for 2,341 individuals with stomas using EuroQol-5D-5L (EQ-5D-5L). Applying a repeated measures regression, we analysed the association between HRQoL and the incidence of self-reported PSH in the year following surgery. Using ordinal regressions, we estimated the odds of reporting worse function in each of the five EQ-5D-5L dimensions among those reporting PSH. We estimated the average number of quality-adjusted life days (QALDs) lost in those reporting PSH. Results Patients experiencing PSH reported significantly lower EQ-5D-5L scores at 12 months following stoma formation (−0.099 [95%CI: −0.126 to −0.071]), amounting to 22.3 QALDs lost per-person-per year. Patients reporting PSH at 12 months had more problems in all EQ-5D-5L dimensions. In four of five dimensions, patients with PSH had more than double the odds of reporting worse HRQoL levels; the difference was most substantial for pain/discomfort (odds ratio 2.80 [95%CI: 2.17 to 3.62]). Conclusion Developing PSH significantly reduces HRQoL across a range of health outcomes, including pain/ discomfort, usual activities, self-care, mobility, and anxiety/depression. Therefore, developing and evaluating surgical techniques to prevent PSH is important to reduce the prevalence of PSH following stoma formation. Estimates of HRQoL presented here can be used in cost-effectiveness studies evaluating such interventions.

Keywords: I10; Parastomal hernia; Stoma; Health-related quality of life; EQ-5D-5L; Background (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-025-01768-5

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