Group-based trajectory analysis of postoperative quality of recovery and outcomes after esophagectomy

Numerous guidelines for perioperative care in esophagectomy have been developed to promote postoperative quality of recovery (QoR). However, the trajectories and predictors of QoR based on patient-reported outcome after esophagectomy have not been characterized.

This multicenter, prospective, observational study enrolled 206 patients undergoing esophagectomy. Primary analysis was to estimate the trajectories of QoR using group-based trajectory modeling.

Four distinct QoR trajectories were identified: poor QoR (38, 18.4%), poor to moderate QoR (83, 40.3%), moderate to good QoR (51, 24.8%), and good QoR (34, 16.5%). Secondary analysis revealed that preoperative nutritional risk (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.03-1.23), lower preoperative QoR-15 score (OR, 0.75; 95% CI, 0.61-0.91), longer duration of surgery (OR, 1.02; 95% CI, 1.01-1.04), and higher area under the curve of postoperative pain scores during coughing (OR, 1.22; 95% CI, 1.09-1.36) were significantly associated with the poor QoR trajectory.

Notably, four postoperative QoR trajectories were identified and the predictors for poor QoR trajectory included preoperative nutritional risks, lower preoperative QoR-15 scores, longer surgical duration, and higher postoperative pain scores during coughing.