Development and Validation of the Surgical Recovery Scale (SRS) (original) (raw)
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Development and Feasibility of a Scale to Assess Postoperative Recovery
Anesthesiology, 2010
Background: Good postoperative recovery is increasingly recognized as an important outcome after surgery. The authors created a new Post-operative Quality Recovery Scale (PQRS) that tracks multiple domains of recovery from immediate to long-term time periods in patients of varying ages, languages, and cultures. Methods: The parameters of importance to both clinicians and patients were identified. After an initial pilot study of 133 patients, the PQRS was refined. It consists of six domains (physiologic, nociceptive, emotive, activities of daily living, cognitive, and overall patient perspective). An observational study of 701 patients was performed with the refined PQRS to assess its capacity to evaluate and track recovery and to discriminate between patients. It was conducted in eight countries and in five languages, involving patients more than or equal to 6 yr undergoing elective surgery with general anesthesia. Recovery was assessed before surgery and at multiple time periods postoperatively. Recovery was defined as return to baseline values or better. Results: Seven hundred one patients completed the PQRS. Mean completion time was 4.8 (SD 2.8) min. Recovery scores improved with time. Physiologic recovery was complete in 34% of subjects by 40 min. By the third postoperative day, complete recovery was obtained in 11% of cases (all domains): 48.7% nociceptive, 81.8% emotive, 68.8% activities of daily living, and only 33.5% cognitive. Overall, 95.8% of the patients reported that they were "satisfied or totally satisfied" with their anesthetic care.
How well are we measuring postoperative “recovery” after abdominal surgery?
Quality of Life Research, 2015
Purpose The content validity of patient-reported outcomes (PROs) commonly used to measure postoperative recovery is unknown. The objective of this study was to develop a conceptual framework for recovery after abdominal surgery and to analyze the content of PRO instruments against this conceptual framework. Methods Qualitative methods were used to develop a conceptual framework for recovery. Patients undergoing abdominal surgery and healthcare professionals were interviewed. Recovery-related concepts were identified using a thematic analysis, and concepts were then linked to the International Classification of Functioning, Disability and Health (ICF). The contents of eight PRO instruments that have been used to measure recovery were then examined using this conceptual framework. Results A total of 17 patients and 15 healthcare professionals were interviewed. A total of 22 important recoveryrelated concepts were identified and linked to the ICF. The four most important concepts were ''Energy level,'' ''Sensation of pain,'' ''General physical endurance,'' and ''Carrying out daily routine.'' The number of important recovery-related concepts covered by each instrument ranged from 1 to 22 (mean 7.3 concepts). The SF36 (n = 22), European Organization for the Treatment and Research of Cancer Quality-of-Life Questionnaire-C30 (n = 20), and the Gastrointestinal Quality-of-Life Index (n = 19) covered the greatest number of important recovery concepts. No instrument covered all of the important concepts. Conclusions The comparison of the contents of PRO instruments commonly used to measure postoperative recovery after abdominal surgery demonstrated major gaps in the representation of concepts that are important to patients and healthcare professionals.
Surgical endoscopy, 2018
We initiated a research program to develop a novel patient-reported outcome measure (PROM) to assess postoperative recovery from the perspective of abdominal surgery patients. In light of FDA recommendations, the first stage of our program aimed to, based on previous literature and expert input, develop a hypothesized conceptual framework portraying the health domains that are potentially relevant to the process of recovery after abdominal surgery. This study was conducted in three phases: (1) systematic review to identify PROMs with measurement properties appraised in the context of recovery after abdominal surgery, (2) content analysis to categorize the health domains covered by the PROMs according to the ICF, and (3) two-round Delphi study to gain expert input regarding which of these health domains are relevant to the process of recovery. Participants were experts in perioperative care identified through two major surgical societies (35 invited). The systematic review identified...
Influences on length of stay in an enhanced recovery programme after colonic surgery
Colorectal Disease, 2011
Aim Enhanced recovery after surgery (ERAS) programmes have been shown to accelerate and enhance functional recovery after colonic surgery. We analysed prospectively collected data to investigate potentially modifiable factors that may influence the length of stay (LOS) in the ERAS setting at a single institution.
Journal of Evaluation in Clinical Practice, 2011
Background. The previously developed Postoperative Recovery Profile (PRP) questionnaire is intended for self-assessment of general recovery after surgery. The aim of this study was to further evaluate the questionnaire regarding the construct validity and ability to discriminate recovery profiles between groups. Furthermore, the item variables of greatest importance during the progress of recovery were investigated.
Enhanced recovery after surgery (ERAS) in patients undergoing colorectal surgeries
Apollo Medicine, 2015
Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured pathway allowing the surgical and anaesthetic teams to decrease the physical insult and aid recovery enabling earlier discharge. 222 patients undergoing elective colorectal surgery-106 cases and 116 controls were included in a prospective comparative study done over a period of two years. Patients were matched for age, gender, co-morbidity, type of disease, American Society of Anesthesiologists (ASA) grade, type of surgery and stoma formation. Primary outcome measures of this study were length of hospital stay, mortality and morbidity. Secondary outcome measures were early oral feeding, return of bowel functions and number of readmissions within 30 days. Mean post-operative hospital stay was 4 days for patients in ERAS group compared to 8.7 days for the control group. There was no significant difference between the ERAS and control group for morbidity (22.6% Vs 31.1%; P = 0.16) and mortality (0% Vs 0.86%; P > 0.05). Regular feeding was tolerated much earlier in ERAS group (3days Vs 7days; P = 0.00). Bowel functions returned earlier in ERAS group (2.9 days Vs 5.3 days; P = 0.00). Readmission within 30 days of discharge was higher for ERAS group (6.6% Vs 0%; P = 0.05). Treatment of colorectal surgery patients according to an enhanced recovery after surgery programme leads to faster recovery and shorter hospital stay. Principles of ERAS programme are applicable and will be most beneficial for the patients.
Validation of a novel postoperative quality-of-life scoring system
The American Journal of Surgery, 2009
BACKGROUND: No specific scoring system exists for the assessment of postoperative quality of life (QOL) after major abdominal surgery. This study prospectively validates PQL, a novel prospective scoring system in patients having laparoscopic or open major abdominal colorectal surgery. METHODS: Six experienced surgeons developed the questionnaire. Twenty patients reviewed and selected the most relevant questions, yielding 14 questions. One hundred patients undergoing a variety of colorectal procedures completed the questionnaire preoperatively, and on postoperative days (POD) 1, 2, 4, 8, 12, 30, and 60. Internal validation was assessed by Cronbach's alpha and factor analysis.