Quality of recovery in hospital and disability-free survival at three months after major abdominal surgery

Abstract

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 ≥ 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.

Fried Frailty Phenotype Questionnaire scores and postoperative patient‐reported outcomes of patients undergoing major abdominal cancer surgery: A secondary analysis

“…This study was approved by the Nara Medical University Institutional Review Board (Kashihara, Nara, Japan; Chairperson, Professor M Yoshizumi; approval number: 2975; 28 April 2021). 14 All participants provided written informed consent before enrollment in the study.…”

“…The inclusion criterion, as defined in the initial study, 14 was patients aged ≥65 years undergoing elective major abdominal surgery for solid malignant tumors. The exclusion criteria were as follows: (i) poor comprehension of the Japanese language; (ii) the presence of dementia or psychiatric disease requiring treatment; (iii) palliative surgery; and (iv) a planned postoperative hospital stay of <3 days.…”