Relation between quality of recovery in hospital and quality of life at 3 months after cardiac surgery

Abstract

Background: Improved quality of life (QoL) is a desirable outcome of cardiac surgery. The aim of the current study was to measure the association between quality of recovery 3 days after surgery and QoL measured 3 months later. Methods: After obtaining ethics committee approval and consent, 120 adult cardiac surgical patients were studied. A 40-item quality of recovery score (QoR-40) was used to measure post-operative health status on days 1-3 and 1 month after surgery. QoL was measured using the short-form health survey (SF-36) at 1 and 3 months after surgery. The effect size (Δmean/SD) was used to define responsiveness, a clinically important difference in health. Associations were measured using correlation and reliability coefficients. Results: There was a significant change in the mean QoR-40 for up to 1 month after surgery (P<0.0005). QoL was improved at 3 months (P<0.0005) but not 1 month (P=0.29) after surgery. There was a moderate correlation between day-3 QoR-40 and 3-month SF-36 (r=0.39; P<0.0005). A poor-quality recovery in hospital predicted a poor QoL at 3 months (adjusted odds ratio, 4.20; 95% confidence interval, 1.41-12.5; P=0.01). Conclusions: The QoR-40 is a valid measure of quality of recovery after surgery and anesthesia. When compared with the SF-36, it is a better measure of early postoperative recovery. A poor-quality recovery on the days after surgery can predict a poor QoL at 3 months after surgery. This may allow earlier and more effective support strategies while patients are still in the hospital (counseling, home assistance, local doctor notification, cardiac rehabilitation).