Changes in quality of life after elective surgery: an observational study comparing two measures

Vanessa L. Kronzer, Michelle R. Jerry, Arbi Ben Abdallah, Troy S. Wildes, Sherry L. McKinnon, Anshuman Sharma, Michael S. Avidan

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Purpose: Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. Methods: This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). Results: By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Conclusions: Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.

Original languageEnglish
Pages (from-to)2093-2102
Number of pages10
JournalQuality of Life Research
Volume26
Issue number8
DOIs
StatePublished - Aug 1 2017

Keywords

  • Elective surgical procedures
  • Minimum clinically important difference (MCID)
  • Outcome assessment
  • Patient-reported outcomes
  • Quality of life

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