Patient-reported recovery after abdominal and pelvic surgery using the Convalescence and Recovery Evaluation (CARE): implications for measuring the impact of surgical processes of care and innovation.

摘要

BACKGROUND: Recovery is an integral part of the surgical process and measuring it provides insight into the impact of surgical innovation. This study used a recently validated instrument, the Convalescence and Recovery Evaluation (CARE), to measure return to baseline health after surgery and explore clinical factors associated with recovery. STUDY DESIGN: Patient health was measured among 96 patients before and after abdominal and pelvic surgery. Patients were grouped by time to recovery of 90% of baseline status. chi2 Tests and logistic models were used to measure relationships between recovery time and patient characteristics, processes of care, and outcomes. RESULTS: Return to baseline health was reached by 44% of patients within 2 weeks, 28% between 2 and 4 weeks, and 28% after 4 weeks. Patients who recovered faster were younger, female, single, and undergoing ambulatory surgery for benign diseases. Patients who were married, underwent surgery for cancer, or had bowel surgery were more likely to require longer recovery time. CONCLUSIONS: Several patient and clinical characteristics were found to be associated with recovery after surgery. CARE appears to be sensitive to these factors and may be useful for informed decision making, assessing changes in processes of care, and evaluating the impact of surgical innovations on recovery.