Development and feasibility of a scale to assess postoperative recovery: the post-operative quality recovery scale.

Abstract:

BACKGROUND:Good postoperative recovery is increasingly recognized as an important outcome after surgery. The authors created a new Post-operative Quality Recovery Scale (PQRS) that tracks multiple domains of recovery from immediate to long-term time periods in patients of varying ages, languages, and cultures. METHODS:The parameters of importance to both clinicians and patients were identified. After an initial pilot study of 133 patients, the PQRS was refined. It consists of six domains (physiologic, nociceptive, emotive, activities of daily living, cognitive, and overall patient perspective). An observational study of 701 patients was performed with the refined PQRS to assess its capacity to evaluate and track recovery and to discriminate between patients. It was conducted in eight countries and in five languages, involving patients more than or equal to 6 yr undergoing elective surgery with general anesthesia. Recovery was assessed before surgery and at multiple time periods postoperatively. Recovery was defined as return to baseline values or better. RESULTS:Seven hundred one patients completed the PQRS. Mean completion time was 4.8 (SD 2.8) min. Recovery scores improved with time. Physiologic recovery was complete in 34% of subjects by 40 min. By the third postoperative day, complete recovery was obtained in 11% of cases (all domains): 48.7% nociceptive, 81.8% emotive, 68.8% activities of daily living, and only 33.5% cognitive. Overall, 95.8% of the patients reported that they were "satisfied or totally satisfied" with their anesthetic care. CONCLUSION:The scores on the PQRS demonstrated an improvement over time, consistent with an expected recovery after surgery and anesthesia, and an ability to discriminate between individuals. Many patients had incomplete recovery by the third postoperative day.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Royse CF,Newman S,Chung F,Stygall J,McKay RE,Boldt J,Servin FS,Hurtado I,Hannallah R,Yu B,Wilkinson DJ

doi

10.1097/ALN.0b013e3181d960a9

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

892-905

issue

4

eissn

0003-3022

issn

1528-1175

journal_volume

113

pub_type

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