Early Patient-Reported Outcomes as Predictors of Long-Term Scar Satisfaction: An Exploratory Cohort Study.

Abstract

Early prediction of long-term scar outcomes is essential for guiding clinical decision-making and improving patient satisfaction. This study investigates whether 3-month patient-reported outcomes (PROs) using SCAR-Q domains-psychosocial, appearance and quality of life (QoL)-predict 12-month outcomes, and how these relate to objective scar measures. A prospective cohort of 20 female patients undergoing various surgical procedures completed SCAR-Q and Patient and Observer Scar Assessment Scale (POSAS) evaluations at 3 and 12 months postoperatively. Correlation and linear regression analyses assessed associations and predictive validity between early and late scar outcomes. SCAR-Q QoL scores demonstrated strong predictive validity (R² = 0.49, p < 0.001; ρ = 0.70, p < 0.001), whereas psychosocial and appearance domains showed weak, nonsignificant associations (R² = 0.12 and 0.10, respectively; p > 0.1). Objective scar characteristics-particularly width and height-were significantly correlated with poorer 12-month appearance and psychosocial scores (e.g., ρ = -0.743 for height vs. appearance, p < 0.001; ρ = -0.605 for width vs. psychosocial, p = 0.0047). In point-biserial correlations, wider and taller scars at 3 months were more likely to be rated as 'bad' at 12 months (r ≥ |0.53|, p ≤ 0.016). POSAS and overall opinion scores also significantly improved over time (p < 0.05), but some patients reported increased appearance-related distress despite objective improvements. In conclusion, early QoL assessments reliably predict long-term outcomes, while appearance and psychosocial perceptions may shift over time. These findings support routine use of PROs in early postoperative care to inform personalised interventions and optimise scar management.