title: Assessment of early cognitive recovery after surgery using the Post-operative Quality of Recovery Scale.
abstract: BACKGROUND
  Cognitive problems early after surgery are often considered transient in nature. Neuropsychological performance and its relation to other recovery parameters have rarely been systematically assessed during this period.
  
  
  METHODS
  A subanalysis of the Post-operative Quality of Recovery Scale (PQRS) feasibility study included patients who completed the PQRS on day 3, and were categorised as recovered or not recovered in the cognitive domain using the revised scoring method.
  
  
  RESULTS
  Of the 449 patients included in this paper, 388 (86.4%) recovered in the cognitive domain and 61 (13.6%) had not recovered at 3 days. Cognitive recovery in the early post-operative time points up to day 1 was significantly lower in patients who had not recovered at day 3 (P < 0.001). Of those not recovered on day 3, 59.1% had recovered on day 1, but lapsed to non-recovery on day 3. The non-recovered group demonstrated less recovery in the physiological (P = 0.019), activity of daily living (P = 0.049) and nociceptive (P = 0.033) domains, but no difference was found in the emotive domain. The non-recovered group had a higher incidence of major surgery (P = 0.021), a higher proportion of patients with difficulty eating (4.9% vs. 0.5%, P = 0.002 and a clinically unimportant but lower temperature (36.6° vs. 36.4°C, P = 0.010).
  
  
  CONCLUSIONS
  Failure of cognitive recovery is reasonably common 3 days after surgery, can fluctuate and is associated with poorer early recovery in the activities of daily living, nociceptive and physiological domains.
authors.affiliation: Faculty of Health Sciences, City University London, London, UK; Department of Health Psychology, University College London Hospitals, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Newman
authors.forename: D J
authors.initials: DJ
authors.lastname: Wilkinson
authors.forename: C F
authors.initials: CF
authors.lastname: Royse
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D003071:Cognition / Q000502:physiology*; D056344:Executive Function; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D059225:Nociception / Q000502:physiology; D009949:Orientation / Q000502:physiology; D011184:Postoperative Period; D012307:Risk Factors; D014888:Wechsler Scales