One in four elective surgery patients report decreased vitality 1 year postoperatively, study finds

A study including 401 patients of various elective surgical procedures found that suboptimal recovery 6 and 12 months after surgical intervention is relatively frequent.

The largest proportion of patients included in the study — performed in the Netherlands and published online by the British Journal of Surgery — were those that underwent orthopedic procedures, with total hip replacement being the most frequently performed operation.

“Our study showed poor recovery was relatively frequent 6 and 12 months after surgery and could be partly explained by various physical and psychological factors,” lead study author Madelon Peters, PhD, stated in a release. “These included acute postoperative pain and presurgical anxiety.”

“We also found a significant association between patients who were worried before their operation about the consequences of surgery and lower than average improvements in physical functioning and vitality at follow-up,” she added.

Study methods

According to the findings, one in seven patients experiences more pain, physical and emotional problems 1 year after surgery than before their operation, and one in four have less vitality — though the researchers did not relate their specific findings in regards to orthopedic patients in the study.

The SF-36 health survey was used to measure pain, physical function, mental health and vitality before surgery and 6 and 12 months after each patient’s operation. Researchers also asked each patient how far they had moved toward a full recovery 6 and 12 months after surgery.

Orthopedic patients made up 133 of the 401 patients who met all necessary criteria and responded fully to surveys. Of these, the most prevalent operations were total hip prosthesis (45), total knee replacement (19) and discectomy (16).

Lasting consequences

“Our research found that 15% of patients were still reporting pain and physical and emotional problems a year after surgery, and 24% felt they had less vitality than before their operation,” Peters stated in the release.

Reportedly, 53% of the 401 patients said their pain levels had improved 12 months after their operation, but 17% reported greater pain. Furthermore, while most patients had better (43%) or similar (43%) functional abilities after 12 months, 14% said their functional abilities had reduced.

According to the study, the strongest predictor of pain intensity at follow-up was the level of pain in the first 4 days after the operation. Poorer long-term physical functioning and overall perceived recovery were also associated with higher levels of acute postoperative pain.

Patients reported an average level of recovery of 79% at 6 months and 82% at 12 months, but only 47% of patients achieved “near optimal” — 90% or more — recovery at 12 months. Fifteen percent of the 401 patients perceived their recovery as 50% or less.

“Most of the changes in health-related quality of life occurred during the first 6 months after surgery, after which the patients’ conditions appeared to remain stable,” Peters stated in the release. “It is clearly important to monitor how patients recover during this period, as an initially poor recovery may have lasting consequences.”

Reference:
Peters ML. Br J Surg. doi:10.1002/bjs.7152.

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