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Poor recovery from elective surgery

Many patients experience more physical and emotional problems a year after elective surgery than they did before their operation, researchers find.

The study

The study team from the Netherlands interviewed 216 women and 185 men, average age 54, who underwent planned surgery, ranging from orthopaedic to cosmetic procedures.

One year after their surgery, 17% of patients said they experienced more pain, 14% said their functional abilities had declined, 16 percent had poorer mental health, and 24% said they had lower vitality than before the surgery.

In terms of overall recovery, the average level of recovery was 79% at six months and 82% at one year after surgery. Only 47% of patients achieved near optimal recovery (defined as 90% or more) after one year, with about 15% of patients reporting their recovery at 50% or less.

The study was released in advance of publication in an upcoming print issue of the British Journal of Surgery.

The findings

"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. These included acute postoperative pain and presurgical anxiety," Dr Madelon Peters of the clinical psychological science department at Maastricht University said.

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

"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."

The majority of changes in patients' health-related quality of life occurred in the first six months after surgery. After that time, the patients' conditions seemed to become stable, the study authors noted.

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


(Copyright © 2010 HealthDay. All rights reserved.)

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