title: Cognitive testing with the Post-Operative Quality of Recovery Scale in pre-surgery cancer patients--a controlled study.
abstract: BACKGROUND
  Post-Operative Quality of Recovery Scale (PQRS) has been revised to allow for the normal variation in cognitive performance seen in healthy volunteers. This modification could result in exclusion of test subjects because of poor baseline performance. Our aim was to investigate the impact of severe disease and waiting for cancer surgery on PQRS baseline cognitive performance and exclusion rate, and also on variation in cognitive performance at test re-test.
  
  
  METHODS
  Sixty-one subjects, 31 women diagnosed with breast cancer and waiting for surgery and 30 healthy women, performed the PQRS cognitive, nociceptive and emotional domains three times in 48 h. Exclusion rate, change in score and the proportion fulfilling 'recovery' criteria at re-tests were assessed.
  
  
  RESULTS
  Nine out of 31 patients (29%) and two out of 30 controls (7%) had too low baseline score to be further assessed (P = 0.043). The change in score at re-tests was similar between the groups. Sixty-four per cent and 83% at 20 h and 79% and 86% at 48 h in the patient and control groups respectively fulfilled the 'recovery' criteria (P = 0.45). The 'recovery' for nociceptive and emotional distress was similar between the groups, but anxiety and sadness absolute scores were significantly higher in the patient group.
  
  
  CONCLUSIONS
  Women with breast cancer waiting for surgery expressed a higher level of emotional distress, performed lower at baseline but showed no difference in test re-test variability in cognitive performance according to the PQRS when compared with controls. The considerable exclusion rate among patients waiting for cancer surgery should be acknowledged.
authors.affiliation: Department of Anaesthesia, Surgical Services and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Lindqvist
authors.affiliation: Department of Anaesthesia, Surgical Services and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Granstrom
authors.affiliation: Department of Anaesthesia, Surgical Services and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Schening
authors.affiliation: Department of Anaesthesia, Surgical Services and Intensive Care, Institution for Physiology and Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Bjorne
authors.affiliation: Department of Anaesthesia and Intensive Care, Institution for Clinical Science, Karolinska Institute, Danderyds Hospital, Stockholm, Sweden.
authors.forename: J G
authors.initials: JG
authors.lastname: Jakobsson
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D003071:Cognition; D004644:Emotions; D005260:Female; D006801:Humans; D008875:Middle Aged; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult