Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2018.06.002
Brazilian Journal of Anesthesiology
Scientific Article

Evaluation of the quality of recovery and the postoperative health status after elective surgery

Avaliação da qualidade da recuperação e do estado de saúde no pós-operatório de cirurgias eletivas

Sofia M. Ferraz; João P. Moreira; Leonor C. Mendes; Tania M. Amaral; Ana R. Andrade; Alice R. Santos; Fernando J. Abelha

http://dx.doi.org/10.1016/j.bjane.2018.06.002 Braz J Anesthesiol, vol.68, n6, p.577-583, 2018
PDF English
PDF Português
Downloads: 0
Views: 725

Abstract

Abstract Purpose: Postoperative recovery is a complex process with physiologic, functional, and psychologic dimensions. Postoperative quality of recovery is considered as a crucial outcome following surgery and anesthesia. The objective of this study was to assess and compare the quality of postoperative recovery and health status before and after surgery, in patients undergoing elective surgery. Methods: This observational, prospective study was conducted on patients proposed for elective surgery. Evaluation of postoperative recovery was performed using the Postoperative Quality of Recovery Scale and health status was assessed by applying the EuroQol assessing problems in five dimensions: mobility, personal care, usual activities, pain/discomfort, and anxiety/depression, and the World Health Organization Disability Assessment Schedule 2.0. Poor quality of recovery was defined as recovery in fewer than two domains at postoperative Day 1 in the Postoperative Quality of Recovery Scale. Results: Before surgery (D0), patients with poor quality of recovery had median Visual Analog Scale scores in EuroQol similar to those of patients without poor quality of recovery, but they had more problems in the mobility, usual activities, pain/discomfort, and anxiety/depression dimensions. At 3 months after surgery, patients with poor quality of recovery had median Visual Analog Scale scores in EuroQol similar to those of patients without poor quality of recovery, but they maintained more problems in the pain/discomfort dimension. Patients with poor quality of recovery scored significantly higher on the World Health Organization Disability Assessment Schedule 2.0 scale at baseline, although the results were similar at 3 months. Conclusions: Patients with poor quality of recovery had the worst health status at D0. Evaluation at 3 months indicated similar rates of problems in EuroQol (except for pain/discomfort) and World Health Organization Disability Assessment Schedule 2.0 scores were similar.

Keywords

Postoperative recovery, Poor quality of recovery, Health status, WHODAS, EQ-5D

Resumo

Resumo Objetivo: A recuperação pós-operatória é um processo complexo com dimensões fisiológicas, funcionais e psicológicas. A qualidade da recuperação pós-operatória é considerada um resultado crucial após cirurgia e anestesia. O objetivo deste estudo foi avaliar e comparar a qualidade da recuperação pós-operatória e o estado de saúde antes e depois da cirurgia em pacientes submetidos à cirurgia eletiva. Métodos: Este estudo observacional prospectivo foi feito com pacientes agendados para cirurgia eletiva. A avaliação da recuperação pós-operatória foi feita com a Escala de Qualidade da Recuperação Pós-Operatória (Postoperative Quality of Recovery Scale) e o estado de saúde foi avaliado com a aplicação do EuroQol, que analisa problemas em cinco dimensões (mobilidade, cuidados pessoais, atividades habituais, dor/desconforto e ansiedade/depressão) e a ferramenta para medida de incapacidade desenvolvida pela Organização Mundial da Saúde (World Health Organization Disability Assessment Schedule 2.0). Má qualidade de recuperação foi definida como uma recuperação em menos de dois domínios da Escala de Qualidade da Recuperação Pós-Operatória no primeiro dia (D1) de pós-operatório. Resultados: Antes da cirurgia (D0), os pacientes com má qualidade de recuperação apresentaram escores medianos na escala visual analógica semelhantes aos dos pacientes sem má qualidade de recuperação, mas apresentaram mais problemas nas dimensões mobilidade, atividades habituais, dor/desconforto e ansiedade/depressão. No terceiro mês após a cirurgia, os pacientes com má qualidade de recuperação apresentaram escores na escala visual analógica medianos no EuroQol semelhantes aos dos pacientes sem má qualidade de recuperação, mas apresentaram mais problemas na dimensão dor/desconforto. Os escores World Health Organization Disability Assessment Schedule 2.0 dos pacientes com má qualidade de recuperação foram significativamente maiores no início do estudo, embora os resultados tenham sido semelhantes no terceiro mês. Conclusões: Os pacientes com má qualidade de recuperação apresentaram o pior estado de saúde no D0. A avaliação no terceiro mês indicou taxas semelhantes de problemas no EuroQol (exceto dor/desconforto) e escores semelhantes no World Health Organization Disability Assessment Schedule 2.0.

Palavras-chave

Recuperação pós-operatória, Má qualidade da recuperação, Estado de saúde, WHODAS, EQ-5D

References

Allvin R, Berg K, Idvall E. Postoperative recovery: a concept analysis. J Adv Nurs. 2007;57:552-8.

Bowyer A, Jakobsson J, Ljungqvist O. A review of the scope and measurement of postoperative quality of recovery. Anaesthesia. 2014;69:1266-78.

Bowyer A, Royse C. The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications. Can J Anaesth. 2016;63:176-83.

Lee L, Tran T, Mayo NE. What does it really mean to "recover" from an operation?. Surgery. 2014;155:211-6.

Neville A, Lee L, Antonescu I. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg. 2014;101:159-70.

Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg. 1970;49:924-34.

Korttila K. Recovery from outpatient anaesthesia Factors affecting outcome. Anaesthesia. 1995;50(Suppl.):22-8.

Bowyer AJ, Royse CF. Postoperative recovery and outcomes - what are we measuring and for whom?. Anaesthesia. 2016;71(Suppl 1):72-7.

Royse CF, Newman S, Chung F. Development and feasibility of a scale to assess postoperative recovery: the post-operative quality recovery scale. Anesthesiology. 2010;113:892-905.

Shulman MA, Myles PS, Chan MT. Measurement of disability-free survival after surgery. Anesthesiology. 2015;122:524-36.

Lee L, Mata J, Augustin BR. A comparison of the validity of two indirect utility instruments as measures of postoperative recovery. J Surg Res. 2014;190:79-86.

van Agt HM, Essink-Bot ML, Krabbe PF. Test-retest reliability of health state valuations collected with the EuroQol questionnaire. Soc Sci Med. 1994;39:1537-44.

Ustün TB, Chatterji S, Kostanjsek N. WHO/NIH Joint Project Developing the World Health Organization Disability Assessment Schedule 2.0. Bull World Health Organ. 2010;88:815-23.

Tanaka Y, Wakita T, Fukuhara S. Validation of the Japanese version of the quality of recovery score QoR-40. J Anesth. 2011;25:509-15.

Guimarães-Pereira L, Costa M, Sousa G. Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study. Braz J Anesthesiol. 2016;66:369-75.

Sá AC, Sousa G, Santos A. Quality of recovery after anesthesia: validation of the portuguese version of the ‘Quality of Recovery 15' questionnaire. Acta Med Port. 2015;28:567-74.

Myles PS, Viira D, Hunt JO. Quality of life at three years after cardiac surgery: relationship with preoperative status and quality of recovery. Anaesth Intensive Care. 2006;34:176-83.

Myles PS, Hunt JO, Fletcher H. Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery. Anesthesiology. 2001;95:862-7.

Leslie K, Troedel S, Irwin K. Quality of recovery from anesthesia in neurosurgical patients. Anesthesiology. 2003;99:1158-65.

Myles PS, Williams DL, Hendrata M. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000;84:6-10.

Buchanan FF, Myles PS, Cicuttini F. Effect of patient sex on general anaesthesia and recovery. Br J Anaesth. 2011;106:832-9.

Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013;118:1332-40.

Myles PS, Hunt JO, Nightingale CE. Development and psychometric testing of a quality of recovery score after general anesthesia and surgery in adults. Anesth Analg. 1999;88:83-90.

Stessel B, Fiddelers AA, Joosten EA. Prevalence and predictors of quality of recovery at home after day surgery. Medicine (Baltimore). 2015;94:e1553.

Gornall BF, Myles PS, Smith CL. Measurement of quality of recovery using the QoR-40: a quantitative systematic review. Br J Anaesth. 2013;111:161-9.

Payakachat N, Ali MM, Tilford JM. Can The EQ-5D detect meaningful change? A systematic review. Pharmacoeconomics. 2015;33:1137-54.

Cieza A, Stucki G. Content comparison of health-related quality of life (HRQOL) instruments based on the international classification of functioning, disability and health (ICF). Qual Life Res. 2005;14:1225-37.

5dcaf9f30e8825772e03b881 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections