KMID : 0356920230760060567
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Korean Journal of Anesthesiology 2023 Volume.76 No. 6 p.567 ~ p.574
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Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery
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Yuki Kinugasa
Nagehan Emiralioglu Shohei Nakatani Kayo Uyama Masahiko Kawaguchi
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Abstract
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Background : The Quality of Recovery-15 (QoR-15) and 12-item World Health Organization Disability Assessment Schedule 2.0 scales are post-surgery patient-reported outcome measures. We aimed to evaluate the association between immediate in-hospital postoperative recovery and mid-term disability-free survival (DFS) after discharge.
Methods : We conducted a prospective observational study at a university hospital and enrolled 260 patients aged ¡Ã 65 years with cancer who were undergoing elective major abdominal surgery. The association between poor postoperative recovery, defined as a QoR-15 score < 90 on postoperative day (POD) 2, and the DFS three months later was assessed using Fisher¡¯s exact test. The odds ratio of poor recovery on POD 2 to DFS was calculated using multiple logistic regression analysis adjusted for prominent factors (age, preoperative frailty, preoperative DFS, surgical duration, and intraoperative blood loss volume).
Results : A total of 230 patients completed the 3-month follow-up. On POD 2, 27.3% of the patients (63/230) had poor recovery. A greater number of patients without poor recovery on POD 2 had DFS at three months after surgery (79.6%) than those with poor recovery (65.1%) (P = 0.026). The adjusted odds ratio of poor recovery on POD 2 to DFS at three months was 0.481 (95% CI [0.233, 0.994]).
Conclusions : Patients with poor recovery on POD 2 were less likely to have DFS three months after abdominal surgery. These findings may allow for early and effective interventions to be initiated based on each patient¡¯s condition after abdominal surgery.
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KEYWORD
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Aged, General surgery, Neoplasms, Operative surgical procedures, Patient outcome assessment, Postoperative complications
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