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Quality of life and need for care in patients with an ostomy: a survey of 2647 patients of the Berlin OStomy-Study (BOSS)

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Although ostomies are sometimes necessary, it is unclear which type of ostomy is advantageous for quality of life (QoL). In an observational study of 2647 patients, QoL after colostomy (CS) and small bowel stoma (SBS) formation was evaluated.


The European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30 and CR-38 questionnaires were used. Patient characteristics, retrospective information about the ostomy and previous treatments, and current stoma-related complications were recorded. All questionnaires were distributed and collected by stoma therapists at the homecare company PubliCare®.


In all, 1790 patients had a CS, and 756 had an SBS. The mean Global Health Score (mGHS—a general QoL indicator) was 52.33 in CS and 49.40 in SBS patients (p = 0.004), but the effect size (Cohen’s d) was 0.1. In SBS patients, all functional scores were lower and most of the symptom scores were higher.


QoL differed significantly for CS and SBS patients, but the effect size was marginal. The care of certain patient groups, particularly (female) patients who receive emergency surgeries, must be improved. More professional education and guidance are necessary for a larger proportion of patients. This survey provided reference data for quality of life in patients with an ostomy.

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  1. Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Holzel D (2003) Quality of life in rectal cancer patients: a four-year prospective study. Ann Surg 238:203–213

    PubMed  PubMed Central  Google Scholar 

  2. Jain S, McGory ML, Ko CY, et al. (2007) Comorbidities play a larger role in predicting health-related quality of life compared to having an ostomy. Am J Surg 194:774–779 discussion 9

    Article  PubMed  Google Scholar 

  3. Pachler J, Wille-Jorgensen P (2012) Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev 12:CD004323

    PubMed  Google Scholar 

  4. Popek S, Grant M, Gemmill R, et al. (2010) Overcoming challenges: life with an ostomy. Am J Surg 200:640–645

    Article  PubMed  Google Scholar 

  5. Vermeulen J, Gosselink MP, Busschbach JJ, Lange JF (2010) Avoiding or reversing Hartmann’s procedure provides improved quality of life after perforated diverticulitis. J Gastrointest Surg 14:651–657

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mahjoubi B, Kiani Goodarzi K, Mohammad-Sadeghi H (2010) Quality of life in stoma patients: appropriate and inappropriate stoma sites. World J Surg 34:147–152

    Article  CAS  PubMed  Google Scholar 

  7. Marquis P, Marrel A, Jambon B (2003) Quality of life in patients with stomas: the Montreux Study. Ostomy Wound Manage 49:48–55

    PubMed  Google Scholar 

  8. Aaronson NK, Ahmedzai S, Bergman B, et al. (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  9. McLachlan SA, Devins GM, Goodwin PJ (1998) Validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) as a measure of psychosocial function in breast cancer patients. Eur J Cancer 34:510–517

    Article  CAS  PubMed  Google Scholar 

  10. Osoba D, Aaronson N, Zee B, Sprangers M, te Velde A (1997) Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. The Study Group on Quality of Life of the EORTC and the Symptom Control and Quality of Life Committees of the NCI of Canada Clinical Trials Group. Qual Life Res Int J Qual Life Asp Treat Care Rehab 6:103–108

    CAS  Google Scholar 

  11. Cull AM (1997) Cancer-specific quality of life questionnaires: the state of the art in Europe. Eur J Cancer 33(Suppl 6):S3–S7

    Article  PubMed  Google Scholar 

  12. Sprangers MA, te Velde A, Aaronson NK (1999) The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). European Organization for Research and Treatment of Cancer Study Group on Quality of Life. Eur J Cancer 35:238–247

    Article  CAS  PubMed  Google Scholar 

  13. Fayers PM (2001) Interpreting quality of life data: population-based reference data for the EORTC QLQ-C30. Eur J Cancer 37:1331–1334

    Article  CAS  PubMed  Google Scholar 

  14. Schwarz R, Hinz A (2001) Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer 37:1345–1351

    Article  CAS  PubMed  Google Scholar 

  15. Cottam J, Richards K, Hasted A, Blackman A (2007) Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Dis 9:834–838

    Article  CAS  PubMed  Google Scholar 

  16. Pengelly S, Reader J, Jones A, Roper K, Douie WJ, Lambert AW (2014) Methods for siting emergency stomas in the absence of a stoma therapist. Ann R Coll Surg Engl 96:216–218

    Article  CAS  PubMed  Google Scholar 

  17. Shabbir J, Britton DC (2010) Stoma complications: a literature overview. Colorectal Dis 12:958–964

    Article  CAS  PubMed  Google Scholar 

  18. Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol Off J Am Soc Clin Oncol 16:139–144

    CAS  Google Scholar 

  19. Guenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D (2007) Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev CD004647

  20. Tilney HS, Sains PS, Lovegrove RE, Reese GE, Heriot AG, Tekkis PP (2007) Comparison of outcomes following ileostomy versus colostomy for defunctioning colorectal anastomoses. World J Surg 31:1142–1151

    Article  PubMed  Google Scholar 

  21. Karadag A, Mentes BB, Uner A, Irkorucu O, Ayaz S, Ozkan S (2003) Impact of stomatherapy on quality of life in patients with permanent colostomies or ileostomies. Int J Color Dis 18:234–238

    Google Scholar 

  22. Watson PG (1983) The effects of short-term postoperative counseling on cancer/ostomy patients. Cancer Nurs 6:21–29

    Article  CAS  PubMed  Google Scholar 

  23. Herlufsen P, Olsen AG, Carlsen B, et al. (2006) Study of peristomal skin disorders in patients with permanent stomas. Br J Nurs 15:854–862

    Article  CAS  PubMed  Google Scholar 

  24. Erwin-Toth P, Thompson SJ, Davis JS (2012) Factors impacting the quality of life of people with an ostomy in North America: results from the dialogue study. J Wound Ostomy Continence Nurs 39:417–422 quiz 23-4

    Article  PubMed  Google Scholar 

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The company PubliCare®, located in Cologne, Germany, supported this study by contacting the patients and collecting the data.

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Correspondence to Gerold Koplin.

Ethics declarations

The Declaration of Helsinki was observed, and consent was obtained from all patients.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Chris Braumann and Verena Müller made equal contributions to the article, and both are considered to be first authors.

Questionnaires were distributed and collected by the homecare company PubliCare GmbH, Am Wassermann 20-22; 50 829 Köln, Germany.

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Braumann, C., Müller, V., Knies, M. et al. Quality of life and need for care in patients with an ostomy: a survey of 2647 patients of the Berlin OStomy-Study (BOSS). Langenbecks Arch Surg 401, 1191–1201 (2016).

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