Quality of recovery after major emergency abdominal surgery: a prospective observational cohort study.

Abstract

BACKGROUND Major emergency abdominal surgery results in high morbidity and mortality. We aimed to describe patient-reported quality of recovery after major emergency abdominal surgery. METHODS A prospective observational cohort study of patients undergoing major emergency abdominal surgery at a University Hospital was conducted in the period between November 2016 and February 2017. Patients were interviewed using the 15-item questionnaire Quality of Recovery (QoR- 15) six times over the first 30 postoperative days. Patients' maximum score of QoR-15 ranging from 0- 150 were divided into four groups depending on recovery status going from poor (score of 0-89), moderate (score of 90-121), good (score of 122-135) to excellent (score of 136-150) recovery. RESULTS A total of 37 patients were included in the trial. At postoperative day (POD) 1 the recovery status of the patients was mainly poor to moderate (poor n=8 (22%), moderate n=23 (62%), good n=4 (11%) and excellent n=2 (5%)). 16 (55%) of the patients reported a poor or moderate recovery within the first 7 days after surgery, which advanced to good or excellent recovery (n=19 (68%)) from POD 14. The patients were not fully recovered at POD 30 (n=18 (62%) had an excellent recovery). CONCLUSIONS Recovery measured by QoR-15 is substantially affected after major emergency abdominal surgery even after 14- and 30 days postoperatively. The patients were poor or only moderately recovered within the first seven postoperative days and only 62% of the patients were fully recovered at postoperative day 30.