Araştırma Makalesi
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CERRAHİ TİPİ DERLENME KALİTESİ SKORUNU ETKİLİYOR MU?

Yıl 2023, , 15 - 17, 30.04.2023
https://doi.org/10.20492/aeahtd.1253968

Öz

Amaç: Cerrahi sonrası derlenme hasta özellikleri, cerrahi işlem ve anestezi gibi çeşitli faktörlerden etkilenen karmaşık bir durumdur. Quality of Recovery-15 (QoR-15) anketi anestezi ve cerrahi sonrası derlenme kalitesini ölçmede kullanılan ve hasta tarafından belirlenen sonuçları olan bir ankettir. Çalışmamızda elektif septorinoplasti veya orta kulak cerrahisi geçirecek hastalarda derlenme kalitesini değerlendirmede QoR-15 ölçeğinin etkinliğini karşılaştırmayı amaçladık.
Gereç ve Yöntem: Çalışmaya etik kurul izni ve hasta onamı alındıktan sonra, septorinoplasti ve orta kulak cerrahisi geçirecek hastalar dahil edildi. Hastaların yaşı, cinsiyeti, ASA skoru, eğitim durumu, cerrahi tipi, anestezi ve cerrahi süresi kaydedildi. Hastalardan operasyondan önce ve operasyondan 24 saat sonra iki kez Quality of Recovery-15 anketini doldurmaları istendi. Anket sonucu alınan puanlar mükemmel, iyi, orta ve kötü olarak sınıflandırıldı.
Bulgular: Çalışmaya 51 septorinoplasti (Grup 1) ve 53 orta kulak cerrahisi geçirecek (Grup 2) toplam 104 hasta dahil edildi. Anestezi ve cerrahi süresi Grup 1’de, Grup 2’ye göre anlamlı uzun bulundu. Preoperatif dönemde değerlendirilen QoR-15 skoru ortalaması her iki grupta 135 puanın üzerinde ve mükemmel grubunda idi. Postoperatif QoR-15 skorları değerlendirildiğinde, Grup 1’de ortalama 122.2±16 ve Grup 2’de 136.4±11.8 olarak saptandı (p=0,0001). QoR-15 skorları grup içi karşılaştırıldığında, her iki grupta postoperatif dönemde preoperatif döneme göre anlamlı azalma olduğu bulundu (p<0,0001).
Sonuç: Hastanın derlenme kalitesini sınıflandırmak, hastaneden taburcu olmaya hazır olup olmadığını değerlendirmek için ek bir araç olabilir. QoR-15 anketi kısa sürede ve hasta tarafından kolay yapılabilmesi nedeniyle, hasta bakımını geliştirmede standart izlem aracı olarak kullanılabilir.

Kaynakça

  • 1.Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000; 84 (1): 6-10.
  • 2.Chazapis M, Walker EMK, Rooms MA, Kamming D, Moonesinghe SR. Measuring quality of recovery-15 after day case surgery. Br J Anaesth. 2016; 116 (2): 241-248.
  • 3.Kara U, Şimşek F, Kamburoğlu H, et al. Linguistic validation of a widely used recovery score: quality of recovery-15 (QoR-15). Turk J Med Sci. 2022; 46(2): 427-435.
  • 4.Neville A, Lee L, Antonescu I, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg. 2014;101(3):159-170.
  • 5.Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000; 84(1): 11-15.
  • 6.Karaman S, Arıcı S, Doğru S, et al. Validation of the Turkish version of the Quality of Recovery-40 questionnaire. Health Qual Life Outcomes. 2014; 12(1): 8.
  • 7.Gornall BF, Myles PS, Smith CL, et al. Measurement of quality of recovery using the QoR-40: a quantitative systematic review. Br J Anaesth. 2013; 111(2): 161-169.
  • 8.Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013;118(6):1332-1340.
  • 9.Kleif J, Gögenur I. Severity classification of the quality of recovery-15 Score - An observational study. J Surg Res. 2018; 225: 101-107.
  • 10.Myles PS, Myles DB, Galagher W, Chew C, MacDonald N, Dennis A. Minimal clinically important difference for three quality of recovery scales. Anesthesiology. 2016;125(1):39–45.
  • 11.Myles PS, Myles DB. An updated minimal clinically important difference for the QoR-15 scale. Anesthesiology. 2021;135(5):934–935.
  • 12.Miller TE, Mythen M. Successful recovery after major surgery: moving beyond length of stay. Perioper Med. 2014;3:4.
  • 13.Bowyer A, Jakobsson J, Ljungqvist O, Royse C. A review of the scope and measurement of postoperative quality of recovery. Anaesthesia. 2014;69(11):1266-1278.
  • 14.Myles PS, Boney O, Botti M, et al. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: patient comfort. Br J Anaesth. 2018;120(4):705–711.
  • 15.Leger M, Campfort M, Cayla C, Lasocki S, Rineau E. Postoperative quality of recovery measurements as endpoints in comparative anaesthesia studies: a systematic review. Br J Anaesth. 2021;126(6):e210–212.
  • 16.Guyatt GH, Juniper EF, Walter SD, Griffith LE, Goldstein RS. Interpreting treatment effects in randomised trials. BMJ. 1998;316(7132):690-693.
  • 17.Selvi O, Azizoğlu M, Temel G, et al. Translation and validation of the Turkish version of the quality of postoperative recovery score QoR-15: A multi-centred cohort study. Turk J Anaesthesiol Reanim. 2022; 50(6): 443-448.
  • 18.Wessels E, Perrie H, Scribante J, Jooma Z. Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa. Anesth Analg. 2021; 133(2): 507-514.
  • 19.Campfort M, Cayla C,Lasocki S, Rineau E, Leger M. Early quality of recovery according to QoR-15 score is associated with one-month postoperative complications after elective surgery. J Clin Anesth. 2022; 78:110638.
  • 20.Smit-Fun VM, Cox PBW, Buhre WF. Role of the anaesthetist in postoperative care. Br J Surg. 2020; 107(2): e8-e10.

DOES TYPE OF SURGERY AFFECT QUALITY OF RECOVERY SCORE?

Yıl 2023, , 15 - 17, 30.04.2023
https://doi.org/10.20492/aeahtd.1253968

Öz

Aim: Postoperative recovery is a complex process affected by various factors such as patient characteristics, surgical procedure, and anesthesia. The quality of recovery-15 (QoR-15) questionaire is a patient-reported outcome measurement of quality of recovery after anesthesia and surgery. In this study, we aimed to measure and compare the effectiveness of the QoR-15 questionaire in patients undergoing septorhinoplasty and chronic otitis media surgeries under general anesthesia.
Material and Method: After obtaining institutional ethics committee approval and patient consent, patients scheduled for elective septorhinoplasty and chronic otitis media surgeries were enrolled to the study. Demographic characteristics, ASA score, educational status, type of surgery, duration of anesthesia and surgery were recorded. Patients completed the QoR-15 questionaire preoperatively and 24 hours postoperatively. The scores of the questionaire were classified as excellent, good, moderate and bad.
Results: A total of 104 patients presenting for elective septorhinoplasty (Group 1, n=51) and chronic otitis media surgery (Group 2, n=53) were included in the study. Duration of anesthesia and surgery were found longer in Group 1 compared to Group 2. The mean QoR-15 scores were above 135 points in both groups and classified as excellent, preoperatively. The mean postoperative QoR-15 scores were 122,2±16 and 136,4±11,8 in Group 1 and 2, respectively (p=0,0001). In within group comparisons, there was a significant decrease in postoperative QoR-15 scores compared to preoperative scores in both groups (p<0,0001).
Conclusion: To evaluate and classify the patient’s recovery could guide the physician to assess the readiness for discharge from hospital. As the QoR-15 questionaire can be performed easily and in a short time by the patient, it can be used as a standard follow-up tool to improve patient care.

Kaynakça

  • 1.Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000; 84 (1): 6-10.
  • 2.Chazapis M, Walker EMK, Rooms MA, Kamming D, Moonesinghe SR. Measuring quality of recovery-15 after day case surgery. Br J Anaesth. 2016; 116 (2): 241-248.
  • 3.Kara U, Şimşek F, Kamburoğlu H, et al. Linguistic validation of a widely used recovery score: quality of recovery-15 (QoR-15). Turk J Med Sci. 2022; 46(2): 427-435.
  • 4.Neville A, Lee L, Antonescu I, et al. Systematic review of outcomes used to evaluate enhanced recovery after surgery. Br J Surg. 2014;101(3):159-170.
  • 5.Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth. 2000; 84(1): 11-15.
  • 6.Karaman S, Arıcı S, Doğru S, et al. Validation of the Turkish version of the Quality of Recovery-40 questionnaire. Health Qual Life Outcomes. 2014; 12(1): 8.
  • 7.Gornall BF, Myles PS, Smith CL, et al. Measurement of quality of recovery using the QoR-40: a quantitative systematic review. Br J Anaesth. 2013; 111(2): 161-169.
  • 8.Stark PA, Myles PS, Burke JA. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology. 2013;118(6):1332-1340.
  • 9.Kleif J, Gögenur I. Severity classification of the quality of recovery-15 Score - An observational study. J Surg Res. 2018; 225: 101-107.
  • 10.Myles PS, Myles DB, Galagher W, Chew C, MacDonald N, Dennis A. Minimal clinically important difference for three quality of recovery scales. Anesthesiology. 2016;125(1):39–45.
  • 11.Myles PS, Myles DB. An updated minimal clinically important difference for the QoR-15 scale. Anesthesiology. 2021;135(5):934–935.
  • 12.Miller TE, Mythen M. Successful recovery after major surgery: moving beyond length of stay. Perioper Med. 2014;3:4.
  • 13.Bowyer A, Jakobsson J, Ljungqvist O, Royse C. A review of the scope and measurement of postoperative quality of recovery. Anaesthesia. 2014;69(11):1266-1278.
  • 14.Myles PS, Boney O, Botti M, et al. Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: patient comfort. Br J Anaesth. 2018;120(4):705–711.
  • 15.Leger M, Campfort M, Cayla C, Lasocki S, Rineau E. Postoperative quality of recovery measurements as endpoints in comparative anaesthesia studies: a systematic review. Br J Anaesth. 2021;126(6):e210–212.
  • 16.Guyatt GH, Juniper EF, Walter SD, Griffith LE, Goldstein RS. Interpreting treatment effects in randomised trials. BMJ. 1998;316(7132):690-693.
  • 17.Selvi O, Azizoğlu M, Temel G, et al. Translation and validation of the Turkish version of the quality of postoperative recovery score QoR-15: A multi-centred cohort study. Turk J Anaesthesiol Reanim. 2022; 50(6): 443-448.
  • 18.Wessels E, Perrie H, Scribante J, Jooma Z. Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa. Anesth Analg. 2021; 133(2): 507-514.
  • 19.Campfort M, Cayla C,Lasocki S, Rineau E, Leger M. Early quality of recovery according to QoR-15 score is associated with one-month postoperative complications after elective surgery. J Clin Anesth. 2022; 78:110638.
  • 20.Smit-Fun VM, Cox PBW, Buhre WF. Role of the anaesthetist in postoperative care. Br J Surg. 2020; 107(2): e8-e10.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Meltem Bektaş 0000-0002-8255-5004

Yayımlanma Tarihi 30 Nisan 2023
Gönderilme Tarihi 20 Şubat 2023
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

AMA Bektaş M. CERRAHİ TİPİ DERLENME KALİTESİ SKORUNU ETKİLİYOR MU?. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Nisan 2023;56(1):15-17. doi:10.20492/aeahtd.1253968