Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery

Paul S. Myles, Jennifer O. Hunt, Helen Fletcher, Robert Solly, David Woodward, Susan Kelly

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Abstract

Background: Improved quality of life (QoL) is a desirable outcome of cardiac surgery. The aim of the current study was to measure the association between quality of recovery 3 days after surgery and QoL measured 3 months later. Methods: After obtaining ethics committee approval and consent, 120 adult cardiac surgical patients were studied. A 40-item quality of recovery score (QoR-40) was used to measure post-operative health status on days 1-3 and 1 month after surgery. QoL was measured using the short-form health survey (SF-36) at 1 and 3 months after surgery. The effect size (Δmean/SD) was used to define responsiveness, a clinically important difference in health. Associations were measured using correlation and reliability coefficients. Results: There was a significant change in the mean QoR-40 for up to 1 month after surgery (P<0.0005). QoL was improved at 3 months (P<0.0005) but not 1 month (P=0.29) after surgery. There was a moderate correlation between day-3 QoR-40 and 3-month SF-36 (r=0.39; P<0.0005). A poor-quality recovery in hospital predicted a poor QoL at 3 months (adjusted odds ratio, 4.20; 95% confidence interval, 1.41-12.5; P=0.01). Conclusions: The QoR-40 is a valid measure of quality of recovery after surgery and anesthesia. When compared with the SF-36, it is a better measure of early postoperative recovery. A poor-quality recovery on the days after surgery can predict a poor QoL at 3 months after surgery. This may allow earlier and more effective support strategies while patients are still in the hospital (counseling, home assistance, local doctor notification, cardiac rehabilitation).

Original languageEnglish
Pages (from-to)862-867
Number of pages6
JournalAnesthesiology
Volume95
Issue number4
Publication statusPublished - 2001

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