Expert consensus on the selection of postoperative recovery evaluation scale for cardiac surgery patients based on patient reported outcomes_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 The Expert Group for Cardiac Surgery of National Center for Cardiovascular Quality Control

Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, P. R. China;

Corresponding author：

The Expert Group for Cardiac Surgery of National Center for Cardiovascular Quality Control, Email: zhengzhe@fuwai.com

Keywords：

Cardiac surgery; patient-reported outcome measures; postoperative recovery; expert consensus

DOI：

10.7507/1007-4848.202501031

Video：

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Cardiac surgery is often associated with significant trauma, which can lead to a suboptimal recovery experience for patients. With advancements in cardiovascular surgical techniques, the rates of surgical mortality and complications have significantly decreased, leading to increased attention on patients' subjective recovery experiences after the surgery. Patient-reported outcomes (PROs) refer to the feedback provided directly by patients regarding their health status, functional abilities, and treatment experiences. Accurate assessment and timely intervention of PROs have become a growing area of interest in the academic community, with improvements in certain PROs showing significant correlations with prognostic benefits. However, there remains controversy regarding which dimensions of PROs should be prioritized in the postoperative recovery of cardiac surgery patients and how to select appropriate evaluation scales for these dimensions. We referenced the research progress both domestically and internationally, combined with clinical practices from around the world, and widely solicited expert opinions to reach a consensus on the evaluation dimensions of postoperative PROs for cardiac surgery patients. This includes the overall recovery status of patients (surgical recovery, quality of life) and its nine dimensions (pain, physiology, sleep, thirst, frailty, activity, cognition, mental health, and social support). This consensus comprehensively considers the application of PROs scales, and introduces 1-3 scales with the widest application and most solid evidence for each dimension, aiming to further standardize the evaluation dimensions of PROs after cardiac surgery in China and the selection of scales for each dimension.

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4. Subramanian M, Kozower BD, Brown LM, et al. Patient-reported outcomes in cardiothoracic surgery. Ann Thorac Surg, 2019, 107(1): 294-301.
5. 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.
6. Bu XS, Zhang J, Zuo YX. Validation of the Chinese version of the quality of recovery-15 score and its comparison with the post-operative quality recovery scale. Patient, 2016, 9(3): 251-259.
7. Jeanneteau A, Demarquette A, Blanchard-Daguet A, et al. Effect of superficial and deep parasternal blocks on recovery after cardiac surgery: Study protocol for a randomized controlled trial. Trials, 2023, 24(1): 444.
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9. Wisløff T, Hagen G, Hamidi V, et al. Estimating QALY gains in applied studies: A review of cost-utility analyses published in 2010. Pharmacoeconomics, 2014, 32(4): 367-375.
10. Luo N, Johnson JA, Shaw JW, et al. Self-reported health status of the general adult U. S. population as assessed by the EQ-5D and Health Utilities Index. Med Care, 2005, 43(11): 1078-1086.
11. Claessens J, Goris P, Yilmaz A, et al. Patient-centred outcomes after totally endoscopic cardiac surgery: One-year follow-up. J Clin Med, 2023, 12(13): 4406.
12. Hansen TB, Zwisler AD, Berg SK, et al. Cost-utility analysis of cardiac rehabilitation after conventional heart valve surgery versus usual care. Eur J Prev Cardiol, 2017, 24(7): 698-707.
13. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Ⅰ. Conceptual framework and item selection. Med Care, 1992, 30(6): 473-483.
14. 李鲁, 王红妹, 沈毅. SF-36健康调查量表中文版的研制及其性能测试. 中华预防医学杂志, 2002, 36(2): 109-113.Li L, Wang HM, Shen Y. Development and psychometric tests of a Chinese version of the SF-36 Health Survey Scales. Chin J Prev Med, 2002, 36(2): 38-42.
15. Akowuah EF, Maier RH, Hancock HC, et al. Minithoracotomy vs conventional sternotomy for mitral valve repair: A randomized clinical trial. JAMA, 2023, 329(22): 1957-1966.
16. Nasso G, Bonifazi R, Romano V, et al. Three-year results of repaired Barlow mitral valves via right minithoracotomy versus median sternotomy in a randomized trial. Cardiology, 2014, 128(2): 97-105.
17. Deutsch MA, Krane M, Schneider L, et al. Health-related quality of life and functional outcome in cardiac surgical patients aged 80 years and older: A prospective single center study. J Card Surg, 2014, 29(1): 14-21.
18. Ascione R, Reeves BC, Taylor FC, et al. Beating heart against cardioplegic arrest studies (BHACAS 1 and 2): Quality of life at mid-term follow-up in two randomised controlled trials. Eur Heart J, 2004, 25(9): 765-770.
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Latest ArticlesExpert consensus on the selection of postoperative recovery evaluation scale for cardiac surgery patients based on patient reported outcomes

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