Background and Goal of Study: The Postoperative Quality of Recovery Scale (PQRS) objectively measures patient recovery in multiple domains. It is an increasingly important measure of postoperative health status. We aimed to assess the quality of postoperative recovery and the health status in patients scheduled for neoplastic surgery.
Materials and Methods: After approval by the institutional ethics committee, an observational prospective study was conducted in 148 patients admitted at PACU after plastic, gynecologic, urologic and general curative neoplastic surgery. Exclusion criteria: age < 18 years old and inability to give informed consent. PQRS was applied before (T0) and after surgery, at minute 15 (T15) and 40 (T40), at day 1 (D1) and 3 (D3) evaluating recovery in five domains: physiological (PD), nociceptive (ND), emotive (ED), cognition (CD) and activities of daily living (AD). Patients also answered to the Quality of Recovery 15 Score (QoR­15) at T0 and at D1. Recovery on PQRS was defined as return to baseline values or better for all questions within each domain. Poor quality of recovery (PQR) was defined as recovery in less than 2 domains at D1. The Mann­Whitney test, Chi­ square or Fisher's exact test were used for comparisons.
Results and Discussion: In this study, 139 patients were included and 21% were identified as having PQR. There were no differences in age, gender, BMI, ASA status and length of hospital stay. PQR patients presented lower median scores on total QoR­15 before surgery (115 vs. 132, p< 0.001) but at D1 total QoR­15 were similar (108 vs. 115, p=0.101). Duration of anaesthesia was longer in patients with PQR (170 vs. 145 min, p=0.005). In these patients, recovery evaluated by PQRS was less frequent complete, namely on PD at T40 (11.1% vs. 32.7%, p=0.031) and D1 (37.9% vs. 83.6%,p< 0.001); on ND at T15 (48.3.% vs. 82.7%, p< 0.001), at T40 (44.4% vs 76.4%, p=0.001) and D1 (44,8% vs. 80%,
p< 0.001); on ED at T15 (13.8% vs. 38.2, p=0.014), at T40 (11.1% vs. 39.1%, p=0.006) and D1 (3.5% vs. 48.3% ,p< 0.001). Patients with PQR also recovered less frequently at D1 on CD (0% vs. 23.6%, p=0.002) and on AD (14.8% vs. 20.9%, p=0.001).
Conclusion(s): Neoplastic surgery were longer in patients with PQR according to PQRS and their recovery was less frequent at minute 15 and 40, at D1, but not at D3. PQR was associated with a worst health status before surgery, according to QoR­15.

Poor quality recovery after neoplastic surgery according to postoperative quality of recovery scale