The 8-Item Short-Form Health Survey and the Physical Comfort Composite Score of the Quality of Recovery 40-Item Scale Provide the Most Responsive Assessments of Pain, Physical Function, and Mental Function During the First 4 Days After Ambulatory Knee Surgery with Regional Anesthesia

Center for Research on Health Care, and Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
Anesthesia and analgesia (Impact Factor: 3.47). 01/2008; 105(6):1693-700, table of contents. DOI: 10.1213/01.ane.0000287659.14893.65
Source: PubMed

ABSTRACT We evaluated the validity and responsiveness of three instruments: the numeric rating scale (NRS) pain score, the 8-item Short-Form Health Survey (SF-8), and the 40-item Quality of Recovery from Anesthesia (QoR) Survey in 154 outpatients undergoing anterior cruciate ligament reconstruction (ACLR). The objective was to provide a robust psychometric basis for outcome survey selection for surgical outpatients undergoing regional anesthesia without general anesthesia.
Patients undergoing ACLR with a standardized spinal anesthesia plan were randomized to receive a perineural catheter with either placebo injection-infusion, or injection-infusion with levobupivacaine. Patients completed the NRS, SF-8, and QoR instruments for four postoperative days to evaluate pain, physical function, and mental function.
Regarding pain, neither the NRS nor the QoR offered advantages over the SF-8. Regarding physical function, the QoR physical independence composite offered no advantage over the SF-8 physical component summary. The QoR physical comfort composite assessed short-term changes in treatment-related side effects, and thus provided information not covered by the SF-8. Regarding mental function, the SF-8 mental component summary and QoR emotional state composite showed little change over the four days, although the latter measure showed higher responsiveness to change.
For ACLR outpatients receiving regional anesthesia, the SF-8 is sufficient to assess postoperative pain and physical function. Adding the QoR physical comfort composite will help assess short-term side effects.

Download full-text


Available from: Doris McGartland Rubio, Sep 28, 2015
412 Reads
  • Source
    • "Various studies have revealed that the QoR-40 score showed a substantial correlation with the SF-36 score in patients after cardiac surgery [3,4]. Moreover, Bost et al. demonstrated that the 8-Item Short-Form Health Survey (SF-8), used with a QoR-40 questionnaire to assess the postoperative health status in patients after knee surgery, yielded a satisfactory psychometric evaluation [7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The Quality of Recovery-40 questionnaire (QoR-40) is a self-rated questionnaire used to assess the postoperative recovery quality and health status of patients in the early stages following surgery; however, there is no Turkish version of the QoR-40. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the QoR-40 (QoR-40 T). After the approval of the ethics committee, a total of 137 patients completed the questionnaire during the preoperative period, on the third day, and one month after surgery. The quality of life was evaluated by using a health-related quality of life questionnaire (Short-Form Health Survey-36; SF-36) on the third day and one month after surgery. Reliability, feasibility, and validity were assessed to validate the QoR-40 T. The Cronbach's alpha of the global QoR-40 T on the third day after surgery was 0.936. A positive moderate correlation was obtained between the physical comfort, emotional state, physical independence, and pain dimensions of the QoR-40 T and the physical component summary, mental health, physical functioning, and bodily pain subscales of the SF-36 on the third day after surgery, respectively (physical comfort - physical component summary, rho = 0.292, p = 0.001; emotional state - mental health, rho = 0.252, p = 0.003; physical independence - physical functioning, rho = 0.340, p < 0.01; pain - bodily pain, rho = 0.381, p < 0.01). The standardized responsive mean of the total QoR-40 T was 0.62. The QoR-40 T showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.
    Health and Quality of Life Outcomes 01/2014; 12(1):8. DOI:10.1186/1477-7525-12-8 · 2.12 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Qualitätssicherung ist eine vom Gesetzgeber im Rahmen der Strukturreform im Gesundheitswesen vorgeschriebene Maßnahme. Neben der Strukturqualität und Prozessqualität beinhaltet diese Forderung auch die Qualitätssicherung und Optimierung der Ergebnisse. In der vorliegenden Arbeit konnte gezeigt werden, dass die deutsche Übersetzung des Quality-of-Recovery-40-Fragebogens (QoR-40) eine Möglichkeit darstellt die postoperative Qualität der Erholung als Maß der Patientenzufriedenheit zu messen. In der Zukunft muss die Zuordnung der 40 Fragen zu Dimensionen weiter überprüft werden und die Aussagekraft des deutschen Fragebogens im Vergleich zu anderen validierten Fragebögen wie z.B. dem PPP-33 untersucht werden. Darüber hinaus sollte die diskriminative Aussagekraft an unterschiedlichen Patientenkollektiven überprüft werden. In the past years the evaluation of quality of medcine has become of interest. Besides structural and processing quality the quality of results from a patient-centered point of view has to be evaluated. A german translation of the Quality-of-Recovery-Score-40 (QoR-40) has shown to be a valid instrument to assess this part of quality.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This paper proposes a system that identifies the position and orientation of hand bones from magnetic resonance (MR) volume images by registration of a bone model. Investigation of the link structure of a human hand requires the measurement of the relative movement of the bones by identifying each bone configuration among a large number of hand poses of the same subject. To save total time in acquiring bone configurations, a three-step process implemented: (1) a bone polygonal mesh is generated for a bone model by manually segmenting the bone region from one of the MR scanning data; (2) the initial configuration of the bone model is set manually; and (3) the bone model is aligned in MR voxel data to maximize the performance indices. Experimental results show the validity of the identified configurations of the bones by the proposed system when compared with manually generated bone mesh configurations.
    Intelligent Robots and Systems, 2004. (IROS 2004). Proceedings. 2004 IEEE/RSJ International Conference on; 11/2004
Show more