Health-Related Quality of Life Changes in Patients with Digestive Cancers and Chronic Digestive Diseases: A Prospective, Multicenter Study

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Background: This study sought to appraise health-related quality of life (HRQoL) one year after admission in persons with digestive cancer and chronic digestive diseases, stratified by nutritional status on hospital admission, and to identify clinical predictors of HRQoL. Methods: HRQoL questionnaires were completed on admission and after 12 months by a prospective cohort of 560 persons with digestive cancers and digestive chronic diseases. Between 2020 and 2021, among the 926 patients admitted to the study, a prospective cohort of 560 persons with digestive cancers or digestive chronic diseases completed HRQoL questionnaires at admission and after 12 months. Nutritional status was assessed using MUST and GLIM criteria. Multiple correspondence analyses were used to identify clinically meaningful subgroups of patients. Multivariate analyses were performed to identify HRQoL predictors. Results: Participants had a mean age of 63.4 years; 60.7% were male and 39.3% female. At baseline, 34.81% of participants were classified as malnourished. Scores for mental health (SF-36 MH), role-emotional (SF-36 ER), and vitality (SF-36 VT) were significantly lower among persons with severe malnutrition and colorectal cancer (CRC) (p = 0.001, p = 0.004 and p = 0.009, respectively). Regarding changes in HRQoL over one year, persons with severe malnutrition at baseline showed the greatest improvement in mental health (SF-36 MH) within the CRC group (p = 0.01). Among persons with cancer, polypharmacy was consistently associated with poorer outcomes, with significant negative associations across EuroQoL (p < 0.001), SF-36 Social Functioning (p < 0.001), and General Health (p < 0.001). In persons with digestive diseases, length of admission was inversely associated with Physical Role (p < 0.05) and Body Pain (p < 0.05). Finally, GLIM status displayed limited associations, only significant in the case of Vitality and Body Pain (p < 0.05 in both). Conclusions: HRQoL in patients with oncological and digestive diseases is shaped by a complex interplay of clinical and sociodemographic factors.

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