Postoperative recovery in orthopedic surgery: Exploring the roles of pain intensity, opioid consumption, pain catastrophizing, and emotional distress

Abstract

Background

Quality of Recovery (QoR) is a multidimensional construct that includes physical, psychological, and functional domains and is a key indicator of surgical outcomes. Better QoR is linked to shorter hospital stays, fewer complications, and greater patient satisfaction.

Purpose

This study evaluates the QoR of postoperative orthopedic patients in Jordan, focusing on the impact of pain, pain management, and emotional distress on recovery.

Methods

A cross-sectional study was conducted with 300 postoperative orthopedic patients within 24 h of surgery. Data included demographic and clinical information, preoperative and postoperative pain, and patient-reported outcomes using the Depression Anxiety and Stress Scale (DASS), Pain Catastrophizing Scale (PCS), and the Quality of Recovery-40 (QoR-40) questionnaire. Statistical analyses included t-tests, ANOVA, correlation, and linear regression.

Results

The mean QoR-40 score was 156.48 ± 19.65, with 61 % reporting a "good recovery", 36.7 % an "excellent recovery", and 2.6 % a "poor recovery". Higher preoperative and postoperative pain correlated with lower QoR scores (r = −0.26 and −0.46, p < 0.001). Greater opioid consumption in the first 24 h post-surgery correlated with better recovery (B = 0.28, p = 0.00). Emotional distress, particularly pain catastrophizing (B = −0.22, p = 0.01) and stress (B = −0.48, p = 0.00), was associated with a negative impact on QoR. Additionally, nonsmokers, married individuals, unemployed patients, and those undergoing arthroscopy reported better recovery (p < 0.001).

Conclusion

Findings highlight the importance of integrated physical and emotional management strategies to optimize QoR, reduce complications, and enhance patient satisfaction.