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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Published in:

31-01-2022 | Reports of Original Investigations

Patient prioritization of routine and patient-reported postoperative outcome measures: a prospective, nested cross-sectional study

Authors: Soha Abdellatif, MD, Emily Hladkowicz, MA(Ed), Manoj M. Lalu, MD, PhD, FRCPC, Sylvain Boet, MD, PhD, Sylvain Gagne, MD, FRCPC, Daniel I. McIsaac, MD, MPH, FRCPC

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 6/2022

Abstract

Purpose

Understanding which outcomes matter most and improving outcomes for the growing population of older surgical patients are top priorities for Canadian anesthesia research. Nevertheless, there is little understanding of which outcomes older surgical patients prioritize most highly. We evaluated how older people prioritized six outcomes after elective noncardiac surgery. These outcomes were recommended in core outcome sets for perioperative medicine.

Methods

Following ethical approval, we conducted a prospective, nested, cross-sectional study of people one year after they had major elective noncardiac surgery. Participants were asked to rate the importance of six commonly measured outcomes (complications, length of stay, discharge disposition, days at home, disability score, and developing a new disability) on an 11-point Likert scale. Open-ended questions elicited other preferences. Pairwise comparisons were evaluated using Bayesian multivariate regression. K-means clustering identified subgroups of patients based on overall prioritization. Thematic analysis was applied to open-ended responses.

Results

One hundred and one consecutive participants responded. All outcomes scored at least 7.7/10 on average. Complications and discharge location were most highly rated, but only days at home and length of stay had substantial probability (> 99%) of being rated lower than the other four outcomes. Thematic analysis identified the need for greater procedure-specific information, support services, and physical recovery measures.

Conclusions

Commonly recorded and recommended outcomes are reassuringly relevant to older people; however, system-related measures are less highly valued than those more directly related to health and function. Outcomes may need to be personalized to properly evaluate the success of perioperative care.

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Title: Patient prioritization of routine and patient-reported postoperative outcome measures: a prospective, nested cross-sectional study
Authors: Soha Abdellatif, MD
Emily Hladkowicz, MA(Ed)
Manoj M. Lalu, MD, PhD, FRCPC
Sylvain Boet, MD, PhD
Sylvain Gagne, MD, FRCPC
Daniel I. McIsaac, MD, MPH, FRCPC
Publication date: 31-01-2022
Publisher: Springer International Publishing
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 6/2022
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-022-02191-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Patient prioritization of routine and patient-reported postoperative outcome measures: a prospective, nested cross-sectional study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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