Quality of patient-centred recovery trajectories after different types of surgery: a prospective cohort study
Abstract
BACKGROUND
We sought to measure patient recovery trajectory up to 90 days after surgery using both the 15-item quality of recovery score (QoR-15) (range 0-150) and the number of days alive and at home up to 30 days after surgery (DAH30).
METHODS
This prospective cohort study included adult patients undergoing either elective intermediate (mostly arthroplasty) or cardiac surgery, or day case gastroscopy (control group). We asked eligible patients to record their QoR-15 scores before their procedure and then daily via smartphone text messaging for 2 weeks, then weekly for 2 weeks, and then monthly up to 90 days after their procedure to track recovery trajectory. We also recorded their DAH30. The co-primary endpoints were differences in the nadir and slope of the trajectory of recovery as measured by the QoR-15 scale. Differences between groups were compared using time series analysis.
RESULTS
Of 199 eligible and consenting patients who underwent surgery, 188 (94%) had complete follow-up. Median (interquartile range) nadir QoR-15 scores were 128 (93-145), 87 (70-102), and 70 (60-81) for the gastroscopy, intermediate, and cardiac surgery groups, respectively (P<0.001). Compared with the gastroscopy group (29.9 [29.9-29.9]), the median (IQR) DAH30 was lower in both the intermediate (28.8 [26.1-29.1]) and cardiac (22.9 [18.9-24.1]) surgery groups (each P<0.001). There was an association between the QoR-15 nadir and DAH30 (rho=0.52, P<0.001). Most patients were very satisfied or…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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