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

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY
Korean Journal of Anesthesiology Pub Date : 2023-12-01 Epub Date: 2023-05-10 DOI:10.4097/kja.23082
Yuki Kinugasa, Mitsuru Ida, Shohei Nakatani, Kayo Uyama, Masahiko Kawaguchi
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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.

腹部大手术后3个月的住院康复质量和无残疾生存。
背景:康复质量-15 (QoR-15)和12项世界卫生组织残疾评估表2.0量表是术后患者报告的预后指标。我们的目的是评估住院后立即恢复与出院后中期无残疾生存(DFS)之间的关系。方法:我们在一所大学医院进行了一项前瞻性观察研究,纳入260例年龄≥65岁的癌症患者,这些患者正在接受选择性腹部大手术。术后恢复差(定义为QoR-15评分< 90)与术后3个月后的DFS之间的关系采用Fisher精确检验进行评估。采用多因素logistic回归分析计算POD 2恢复不良与DFS的比值比,剔除突出因素(年龄、术前虚弱、术前DFS、手术时间、术中出血量)。结果:230例患者完成了为期3个月的随访。在POD 2中,27.3%(63/230)的患者恢复不良。术后3个月无POD 2恢复不良患者DFS发生率(79.6%)高于恢复不良患者(65.1%)(P = 0.026)。3个月时POD 2与DFS恢复差的校正比值比为0.481 (95% CI[0.233, 0.994])。结论:腹部手术后3个月,POD 2恢复较差的患者发生DFS的可能性较小。这些发现可能允许根据腹部手术后每位患者的病情进行早期有效的干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
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