Development and validation of the Post-operative Recovery Index for measuring quality of recovery after surgery

Abstract

Purpose: Current methods used to quantify aspects of recovery after surgery and anesthesia tend to be narrowly focused, not patient-rated, or have not been appropriately validated. We set out to develop a quality of recovery score system that is self-report and multi-dimensional, with applicability across various surgeries and surgical settings, from immediately post-surgery through discharge and covering the first 30 days of recovery. Methods: A Post-operative Recovery Index (PoRI) was validated on 225 patients (NValidation=96; NCross Validation=129) who had undergone a surgical procedure within the last 30 days. Domain level internal consistency on the validation and cross validation samples yielded coefficients ranging from r=0.813 to r=0.932, while test-retest reliability yielded stability coefficients ranging from r=0.660 to r=0.881. Confirmatory factor analyses demonstrated validity of the factorial structure of the 37-item PoRI on the validation patient sample and confirmed on the cross validation patient sample. Exploratory psychometric analyses provided evidence of an overarching (second-order) "Recovery" factor. Results: We developed, tested, validated, and cross validated the Post-operative Recovery Index (PoRI) consisting of 37 items assessing symptomatology a patient may experience after surgery. Conclusion: The PoRI is offered as a valid, multidimensional measure of recovery after surgery and anesthesia with broad applicability in post-surgical settings. © 2012 Butler SF, et al.