Postoperative Recovery Outcomes Measurements after Day Surgery –
An Evidence-Based Review
Francisco J Herrera MD, Jean Wong MD, Frances Chung MD
Department of Anesthesia, Toronto Western Hospital, 399 Bathurst St., Toronto, Ontario M5T 2S8

INTRODUCTION: Postoperative recovery is a complex process involving different outcomes such as physiological endpoints, adverse events, and psychological status. The purpose of the study is to conduct a systematic review of the existing evidence in the literature related to recovery outcome measurement after ambulatory surgery.
METHODS: A search was performed combining the following terms: postoperative recovery, day surgery, reliability and validity in Ovid MEDLINE® (from 1966 through November 2004), Ovid EMBASE® (from 1980 through week 48th 2004), CINAHL (from 1982 through November 3rd week 2004), HAPI (1985-September 2004), PsycINFO (1985 to October Week 4 2004), Web of Science Search History (1945-2004), Biosys Previews Search (1980- November 2004), Ovid HealthStar® (1975- November 2004) and ASSIA (1987- November 2004) to identify and review studies related to early postoperative recovery outcome measurements within one week after ambulatory surgery. The analysis of the papers was based on the
Guidelines for How to Use Articles About Health Related Quality of Life (1).
RESULTS: Only 5 out of 316 articles reviewed met the inclusion criteria. Three of the studies included only ambulatory patients and two included both ambulatory and inpatients. Two of the instruments used scales that were validated on non-surgical patients. Aspects of life important to patients were taken into consideration in the pre-test of the scale and description of the scale’s developmental process (i.e. item generation) in four of the analyzed papers. Most of the determinants of quality of recovery were included in
the analyzed instruments (Table). Validity and reliability were determined in the majority of the instruments (Table).

Mixed= Multiples types of surgery, HRS= Hernia repair surgery
CONCLUSION: The studies included in the analysis do not always provide indications that allow an expedited interpretation in the scores, reducing its usefulness for evaluation of recovery in daily clinical practice. Quality of postoperative of recovery in ambulatory patients can be better assessed by instruments with strong
validation criteria.
Reference:
1. JAMA 1997; 277: 1232-

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