Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery

Abstract

Predictors for postoperative recovery after colorectal cancer surgery are usually investigated in relation to length of stay (LoS), readmission, or 30-day morbidity. This study describes patient characteristics and surgery-related factors associated with patient-reported recovery 1 and 6 months after surgery. In total, 153 consecutively included patients who were recovering from colorectal cancer surgery reported their level of recovery using the Postoperative Recovery Profile. Multiple logistic regression analysis was used to calculate associations with recovery, defined as good or poor, divided into five recovery dimensions: physical symptoms, physical functions, psychological, social and activity. Better preoperative health predicted good recovery regarding three dimensions 1 month after surgery. Regarding all dimensions 1 month after surgery, poor recovery was predicted by a poor recovery on the day of discharge within corresponding dimensions. Higher age was associated with good recovery 6 months after surgery, while chemotherapy showed negative associations. Overall, a majority of factors had a negative impact on recovery, but without any obvious relation to one specific dimension or point in time. Those factors were: high Body Mass Index, comorbidity, abdominoperineal resection, loop ileostomy, colostomy and LoS. This study illustrates the complexity of postoperative recovery and a need for individualised follow-up strategies.

When experiencing a surgery: Gastrointestinal cancer patients’ longitudinal trajectories in psychological stress and their association with quality of recovery

“…Higher cortisol levels and lower NK-cell activity in DC from 7 to 9 days after surgery to discharge than CC might entail insulin resistance, hyperglycemia, and immune dysfunction, increasing the risk of infection, and leading to worse quality of recovery. 5 , 19 , 43…”

“… 2 , 3 , 4 Few studies have found that perioperative stress could aggravate postoperative physical impairment (eg, pain and fatigue), increase the risk of postoperative complications, and delay patients' postoperative recovery. 3 , 5 , 6 Beyond in-hospital recovery, there is emerging evidence that surgery-related psychological stress may also potentially trigger tumor dissemination. 3 , 7 Given the potential adverse effects of psychological stress, there is a need to pay more attention to managing patients’ psychological stress during the short perioperative timeframe to maintain the mental health of gastrointestinal cancer patients.…”

Predictors of Postdischarge Surgical Recovery Following Laparoscopic Sacrocolpopexy: A Prospective Cohort Study

“…One strength of this study is its use of the validated PSR13 for confirming established predictors of postdischarge surgical recovery in both an expected and unexpected direction. Medical co-morbidities (6–7) and perioperative complications (6), (8–10), were negatively associated with postdischarge surgical recovery, beginning early in its trajectory in the expected direction. The ability to reduce the severity of prolapse with reconstructive surgery translated into better postdischarge surgical recovery as expected, at 42 to 90 days likely mediated by a “return to normalcy” once the negative impact of medical co-morbidities and perioperative complications ran their course.…”

“…Unresponsive statements such as “it depends”, or “I am not sure” are largely based on observations that recovery time varies widely among patients undergoing similar surgeries (3), (4), and (5). Sociodemographic/clinical and surgical predictors including age (6), (7), (8), body mass index (7), (9), medical co-morbidities (6), (7), and surgical complications (6), (8), (9), (10) have been found to be important predictors of recovery from a variety of surgeries.…”

Patient-Reported Outcomes in Surgical Oncology: An Overview of Instruments and Scores

“…It contains elements in the dimensions of symptoms, function, psychological, social and activity. This instrument identified several factors that seemed to be related to poorer recovery, and patients with these issues may benefit from individualized follow-up routines during the recovery period [88].…”