Background and Goal of Study: Quality of recovery (QoR) after anaesthesia is an important  measure of the early postoperative health status of patients. The Quality of Recovery 15 (QoR-15)  score has been shown to be correlated with postoperative quality of life (QoL). This study aims to  determine the incidence and impact of poor quality of recovery (PQR) after surgery in patients ́ QoL  and disability, 3 months after surgery (T2). 
Materials and methods: After approval by the  institutional ethics committee, an observational, prospective study was performed in patients  scheduled for elective surgery under general anaesthesia. Were studied 208 patients admitted to  the Post Anaesthetic Care Unit after plastic, gynaecologic, urologic and general surgery. Exclusion  criteria were: age< 18 years and inability to give informed consent or to speak Portuguese language  fluently. Patients' demographics and perioperative data were collected. The QoR-15 score was  applied preoperatively (T0) and 24h after surgery (T1). PQR were defined for patients having a  QoR-15 score lower than the mean QoR-15 score at T1 minus 1 standard deviation. The EuroQOL  5 dimensions (EQ-5D) and 12-itens WHODAS questionnaires were used to measure QoL and  disability (respectively), at T0 and T2. Patients with a WHODAS≥ 25 were considered disabled.  Non-parametric tests were used for comparisons and Chi-square or Fisher tests for categorical  variables. 
Results and discussion: PQR was present in 17% of the 182 patients included. PQR  patients had lower median QoR-15 scores at T0 (128 vs 140, p=0.002) and T1 (81 vs 127, p<  0.001). At T0, PQR patients had more problems in anxiety dimension of EQ-5D (83% vs 55%,  p=0.003). At T2, PQR patients had similar scores in EQ-5D dimensions and Visual Analogue Scale  (VAS). Comparing EQ-5D VAS scores at T0 and T2 for both groups separately, differences were  found between the two evaluations only for non-PQR patients (p=0.036), with better scores at T2.  At T2, patients with PQR had similar rates of disability and WHODAS scores. When considered  both groups separately, WHODAS scores at T2 were significantly better than at T0 (PQR patients,  p=0.003; non-PQR patients, p< 0.001). 
Conclusion(s): PQR patients had lower scores for QoR-15,  even before surgery. In patients without PQR, scores for EQ-5D VAS improved after surgery; in  contrast to PQR patients for whom there were no improvements. Three months after surgery,  patients were less disabled independently of their QoR.

Impact of poor quality of recovery in the medium term quality of life