The Quality of Recovery-15 score as a Patient-Reported Outcome Measure for anesthesia and surgery after total hip and total knee arthroplasty

Abstract

Background: The Quality of Recovery-15 score is a patient-reported outcome questionnaire measuring the quality of recovery after anesthesia and surgery.

Objectives: To identify the optimal moment of scoring (after which the score no longer improves), explore why patients choose not to participate, and determine the dropout rate, as these outcomes can indicate whether the score could be suitable as a patient-reported outcome measure for anesthesia and surgery after total hip and knee arthroplasty.

Design and setting: A single-center cohort study in a regional general hospital of patients undergoing total hip or knee arthroplasty between April 2019 and March 2020. The Quality of Recovery-15 questionnaire was presented on postoperative days +1, +4, +7, +14 and +28.

Results: Of 374 patients screened for inclusion, 253 patients entered the study. 162 dropped out. Ninety-one patients ended the study, 46 for total hip arthroplasty, 45 for total knee arthroplasty. Scores improved for total hip arthroplasty between D1-D7 (p < 0.001), D1-D14 (p < 0.0001), D1-D28 (p < 0.0001), D4-D14 (p < 0.0001), D4-D28 (p < 0.0001), and D7-D28 (p = 0.003), and for total knee arthroplasty between D1-D14 (p < 0.0001), D1-D28 (p < 0.0001), D4-D28 (p < 0.0001) and D7-D28 (p < 0.0001)..

Conclusions: Although there are indications of a ceiling effect between D14-D28, we could not determine an optimal moment to score the Quality of Recovery-15, as the patients continued to improve 28 days after surgery. This score could be useful in identifying patients at a risk of impaired recovery. Despite efforts to limit this, we observed a high dropout rate, which could compromise the usefulness of this score as a patient-reported outcome measure.