Postoperative recovery and its association with health-related quality of life among day surgery patients

Katarina Berg, Karin Kjellgren, Mitra Unosson, Kristofer Arestedt, Katarina Berg, Karin Kjellgren, Mitra Unosson, Kristofer Arestedt

Abstract

Background: Day surgery holds advantages for both the patient and the health care organization. However, recovery beyond the first postoperative week and following different types of surgery has not been explored to any greater degree. The current aims were to prospectively describe postoperative recovery and health-related quality of life among different groups of day surgery patients and to explore the association between postoperative recovery and health-related quality of life 30 days after discharge.

Methods: A consecutive sample of 607 adult day surgery patients undergoing orthopaedic, gynaecological or general surgery was included. Postoperative recovery was assessed on days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale and the Quality of Recovery-23 scale. The EQ-5D was used to assess health-related quality of life preoperatively and 30 days following discharge. A repeated measure ANOVA was conducted to evaluate postoperative recovery from day 1 to day 14 and between different surgical groups. Hierarchical multiple linear regression models were used to explore the association between postoperative recovery and health-related quality of life.

Results: Postoperative recovery improved from day 1 to 14 in all surgical groups (p<0.001). The orthopaedic patients had lower postoperative recovery on day 14 compared to the general and the gynaecological patients (p<0.001). Health-related quality of life was lower among orthopaedic patients (p<0.001), even if significant improvements over time were seen in all groups. Recovery on day 7 was associated with health-related quality of life 30 days after the day surgery (p<0.05).

Conclusion: Particularly orthopaedic day surgical patients seem to favour a closer follow-up in order to support recovery and thereby also positively influence health-related quality of life.

Figures

Figure 1
Figure 1
Improvements in recovery between postoperative days 1 to 7,7 to 14 and 1 to 14 in patients undergoing orthopaedic,general and gynaecological day surgery when assessed using the Swedish post-discharge surgery recovery(S-PSR)scale. Means and 95% confidence intervals. *** denotes p<0.001 compared to day 1 and ### denotes p<0.001 compared to day 7 for all three groups separately.
Figure 2
Figure 2
Improvements in recovery between postoperative days 1 to 7,7 to 14 and 1 to 14 in patients undergoing orthopaedic,general and gynaecological day surgery when assessed using the Quality of recovery-23 (QoR-23) scale. Means and 95% confidence intervals. *** denotes p<0.001 compared to day 1 and ### denotes p<0.001 compared to day 7 for all three groups separately.

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