Health-related quality of life in patients following gastrointestinal surgery and liver transplantation: A cross-sectional study from a tertiary care centre in India

Background: Health-related quality of life (HRQOL) is an important patient-reported outcome after gastrointestinal (GI) surgery and liver transplantation. Data from India, where patients present with diverse socioeconomic backgrounds and limited access to post-operative rehabilitation, are scarce. This study aimed to assess HRQOL in patients at 4 weeks following GI surgery, including liver transplantation, and compare the outcomes with non-operated controls. Aim: To assess HRQOL in patients at 4 weeks following major and minor GI surgery, including liver transplantation, and compare the outcomes with non-operated controls using the validated SF-36 questionnaire. Materials and Methods: This cross-sectional observational study was conducted at a Tertiary Care Centre in New Delhi, India. One hundred post-operative patients (50 major surgeries and 50 minor surgeries) and 100 age- and sex-matched non-operated control subjects were enrolled. The short form survey (SF-36) questionnaire (Ware and Sherbourne, 1992) was administered 4 weeks postoperatively. Domain scores (0–100) were calculated using the standard SF-36 scoring algorithm. Between-group differences were assessed using one-way analysis of variance and Chi-square tests (significance: P < 0.05). Results: The major surgery group included 12 liver transplant recipients. The mean SF-36 domain scores were significantly lower in the major surgery group across all eight domains ( P < 0.001). Physical functioning scores: major surgery 45.2 ± 18.4, minor surgery 62.4 ± 15.6 and controls 81.8 ± 12.2. Liver transplant recipients had the lowest HRQOL scores in the major surgery subgroup. Patients who underwent minor surgery also showed significant physical domain impairment relative to controls. Conclusions: GI surgery, particularly major procedures such as liver transplantation, significantly impairs HRQOL at 4 weeks. Structured post-operative rehabilitation, adequate pain management and psychological support are essential, especially in the Indian healthcare context. Longitudinal studies are required to characterise these recovery trajectories.