Recovery trajectories after major abdominal surgery: A retrospective pooled cohort study

Area of Science:

• Surgical outcomes research
• Patient-reported outcome measures
• Postoperative recovery analysis

Background:

• Predicting surgical recovery is complex due to multiple influencing factors.
• Traditional recovery metrics (e.g., length of stay, complications) are well-documented.
• Patient-reported recovery data is often limited, especially for multidimensional trajectories.

Purpose of the Study:

• To describe the multidimensional recovery trajectory of patients after major abdominal surgery.
• To explore factors associated with incomplete overall recovery within 4-8 weeks post-surgery.
• To analyze patient-reported recovery using the Postoperative Quality of Recovery Scale (PostopQRS).

Main Methods:

• Retrospective analysis of pooled cohort data from elective major abdominal surgery patients (2018-2024).
• Recovery assessed using PostopQRS across physiological, nociceptive, emotive, ADL, and cognitive domains.
• Overall recovery defined as achieving preoperative baseline in all domains; length of stay compared between recovered and non-recovered groups.

Main Results:

• 42% of patients achieved overall recovery at 4-8 weeks post-surgery.
• Domain-specific recovery rates: nociception (63%), emotion (81%), ADLs (82%), cognition (83%).
• Patients with incomplete overall recovery experienced significantly longer lengths of stay (11.3 days vs. 7.3 days).

Conclusions:

• A significant proportion of patients (58%) do not achieve full multidimensional recovery by 4-8 weeks after major abdominal surgery.
• Incomplete recovery is associated with increased hospital length of stay.
• Further investigation into multidimensional strategies to enhance postoperative recovery trajectories is warranted.