First Four Postoperative Days May Indicate Future Recovery Prospect

A study of patient’s post-surgery reveals that 15% experience more pain and physical and emotional problems a year afterward and 24% have less vitality.

The study was published online by the British Journal of Surgery.

Additionally, 12 months after the operation 17% reported greater pain, 14% said they experienced reduced functional abilities, and 16% had poorer mental health. The results are partly explained by physical and psychological factors, including postoperative pain in the first four days after surgery and presurcgical anxiety.

The researchers, who were from The Netherlands, spoke to 216 women and 185 men, average age 54. The patients had undergone planned surgery, ranging from plastic to orthopedic.

The team used the SF-36 health survey to measure pain, physical functioning, mental health, and vitality before surgery, and six, and 12 months after each patient’s operation. They also asked patients how far they had moved towards a 100% recovery, six and 12 months after surgery.

“Our study showed poor recovery was relatively frequent six and 12 months after surgery and could be partly explained by various physical and psychological factors” said Dr. Madelon Peters, from the Department of Clinical Psychological Science at Maastricht University, in a press release. “These included acute postoperative pain and presurgical anxiety.”

While most reported their pain had either improved or was stable after 12 months, 17% reported greater pain. Most also reported they had regained the same level of functional abilities or even better, but 14% said their functional abilities had reduced.

For overall recovery, patients reported that their average level of recovery was 79% at six months and 82% at 12 months.

"The strongest predictor of pain intensity at follow-up was the level of pain in the first four days after the patient's operation,” Dr. Peters said. “Higher levels of acute postoperative pain were also associated with poorer long-term physical functioning and overall perceived recovery.”

"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.”

"Most of the changes in health-related quality of life occurred during the first six months after surgery, after which the patients' conditions appeared to remain stable.”

"It is clearly important to monitor how patients recover during this period as an initially poor recovery may have lasting consequences."