Development and feasibility of a scale to assess postoperative recovery: the post-operative quality recovery scale.
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.


CONCLUSIONS
The scores on the PQRS demonstrated an improvement over time, consistent with an expected recovery after surgery and anesthesia, and an ability to discriminate between individuals. Many patients had incomplete recovery by the third postoperative day.
Royse
Colin F
CF
Anaesthesia and Pain Management Unit, Department of Pharmacology, University of Melbourne, Melbourne, Victoria, Australia. colin.royse@unimelb.edu.au
Newman
Stanton
S
Chung
Frances
F
Stygall
Jan
J
McKay
Rachel E
RE
Boldt
Joachim
J
Servin
Frederique S
FS
Hurtado
Ignacio
I
Hannallah
Raafat
R
Yu
Buwei
B
Wilkinson
David J
DJ
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D002648:Child; D003071:Cognition / Q000502:physiology; D003469:Culture; D004644:Emotions / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D008991:Monitoring, Physiologic; D010149:Postoperative Pain / Q000175:diagnosis; D017060:Patient Satisfaction; D010865:Pilot Projects; D011182:Postoperative Care / Q000523:psychology / Q000592:standards*; D011184:Postoperative Period; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult