Sex Similarities in Postoperative Recovery and Health Care Contacts Within 14 Days With mHealth Follow-Up: Secondary Analysis of a Randomized Controlled Trial

Maria Jaensson, Karuna Dahlberg, Ulrica Nilsson, Maria Jaensson, Karuna Dahlberg, Ulrica Nilsson

Abstract

Background: Previous studies have shown that women tend to have a poorer postanesthesia recovery than men. Our research group has developed a mobile phone app called Recovery Assessment by Phone Points (RAPP) that includes the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire to monitor and assess postoperative recovery.

Objective: The aim of this study was to investigate sex differences in postoperative recovery and the number of health care contacts within 14 postoperative days in a cohort of day-surgery patients using RAPP.

Methods: This study was a secondary analysis from a single-blind randomized controlled trial. Therefore, we did not calculate an a priori sample size regarding sex differences. We conducted the study at 4 day-surgery settings in Sweden from October 2015 to July 2016. Included were 494 patients (220 male and 274 female participants) undergoing day surgery. The patients self-assessed their postoperative recovery for 14 postoperative days using the RAPP.

Results: There were no significant sex differences in postoperative recovery or the number of health care contacts. Subgroup analysis showed that women younger than 45 years reported significantly higher global scores in the SwQoR questionnaire (hence a poorer recovery) on postoperative days 1 to 10 than did women who were 45 years of age or older (P=.001 to P=.008). Men younger than 45 years reported significantly higher global scores on postoperative days 2 to 6 than did men 45 years of age or older (P=.001 to P=.006). Sex differences in postoperative recovery were not significant between the age groups.

Conclusions: This study found sex similarities in postoperative recovery and the number of health care contacts. However, subgroup analysis showed that age might be an independent factor for poorer recovery in both women and men. This knowledge can be used when informing patients what to expect after discharge.

Trial registration: ClinicalTrials.gov NCT02492191; https://ichgcp.net/clinical-trials-registry/NCT02492191 (Archived by WebCite at http://www.webcitation.org/6y2UtMbvz).

Keywords: cell phone; mHealth; mobile phone; patient outcome assessment; postoperative complications; postoperative period; sex; telemedicine.

Conflict of interest statement

Conflicts of Interest: UN and the Örebro University Enterprise AB hold shares in RAPP-AB.

©Maria Jaensson, Karuna Dahlberg, Ulrica Nilsson. Originally published in JMIR Perioperative Medicine (http://periop.jmir.org), 26.03.2018.

Figures

Figure 1
Figure 1
Global score (mean) for the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire for men and women (higher scores indicate poorer recovery).
Figure 2
Figure 2
Differences in global score (mean) for the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire by age for men (higher scores indicate poorer recovery). Differences between postoperative days 2 to 6 were statistically significant (P range .001 to .006).
Figure 3
Figure 3
Differences in global score (mean) for the Swedish Web version of the Quality of Recovery (SwQoR) questionnaire by age for women (higher scores indicate poorer recovery). Differences between postoperative days 2 to 10 were statistically significant (P range <.001 to .008).

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