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Evaluation of physical and mental recovery status after elective liver resection

Arnberger, Michaela,b; Vogt, Andreasa; Studer, Peterc; Inderbitzin, Danielc; Pulver, Caroled; Röhrig, Bernde; Jakob, Stephan Md; Greif, Roberta

European Journal of Anaesthesiology (EJA): July 2009 - Volume 26 - Issue 7 - p 559–565
doi: 10.1097/EJA.0b013e328328f552
Original Articles – General

Background and objective This prospective, clinical pilot trial compared the Short Form 36 Health Survey (SF-36) and a nine-item quality of recovery [Quality of Recovery 9 (QoR-9)] survey to assess the 1-week outcome after liver resection and prediction of postoperative complications from baseline values before liver resection.

Methods In 19 patients, the SF-36 was recorded preoperatively (baseline) and on postoperative day (POD) 7. SF-36 z-values (means ± SD) for the physical component summary (PCS) and mental component summary (MCS) were calculated. QoR-9 (score 0–18) was performed at baseline, POD1, POD3, POD5 and POD7. Descriptive analysis and effect sizes (d) were calculated.

Results From baseline to POD7, PCS decreased from −0.38 ± 1.30 to −2.10 ± 0.76 (P = 0.002, d = −1.57) and MCS from −0.71 ± 1.50 to −1.33 ± 1.11 (P = 0.061, d = −0.46). QoR-9 was significantly lower at POD1, POD3 and POD5 compared with baseline (P < 0.050, d < −2.0), but not at POD7 (P = 0.060, d = −1.08). Baseline PCS was significantly lower with a high effect size in patients with complications (n = 12) compared with patients without complications (n = 7) (−0.76 ± 1.46 vs. 0.27 ± 0.56; P = 0.044, d = −0.84) but not baseline MCS (P = 0.831, d = −0.10) or baseline QoR-9 (P = 0.384, d = −0.44).

Conclusions The SF-36 indicates that liver resection surgery has a higher impact on physical health than on mental health. QoR-9 determines the feasible time course of recovery with a 1-week return to baseline. Preoperative impaired physical health might predict postoperative complications.

aUniversity Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

bDepartment of Anaesthesiology and Intensive Care Medicine, Donauspital, Vienna, Austria

cUniversity Department of Visceral and Transplantation Surgery, Inselspital, Switzerland

dUniversity Department of Intensive Care Medicine, Bern University Hospital, University of Bern, Bern, Switzerland

eInstitute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University Mainz, Mainz, Germany

Received 8 September, 2008

Revised 24 November, 2008

Accepted 27 December, 2008

Correspondence to Andreas Vogt, University Department of Anaesthesiology and Pain Therapy, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland Tel: +41 31 632 42 17; fax: +41 31 632 05 54; e-mail:

The data were presented in part at the European Society of Anaesthesiology annual meeting, 2007.

© 2009 European Society of Anaesthesiology