Measurement of disability-free survival after surgery

Dr Mark Shulman, lead author

Dr Mark Shulman is an Alfred anaesthetist and lead author of a new study which followed up more than 500 patients for one year after surgery to track their recovery using a World Health Organization (WHO) measure of disability. The ultimate goal of their research and follow-on studies is to give patients more personally tailored information regarding not only immediate risks and benefits of the surgery, but how well they might recover from surgery in the longer term.

Study detail

Perioperative research has traditionally focused on surrogate outcomes such as length of hospital stay, or clinician focused outcomes such as myocardial infarction, stroke, and other major medical complications. These outcomes occur with varying severity and are of variable significance to patients. 

More recently patient-centred outcome measures have been used to assess perioperative outcomes that are important to the patient, including survival and freedom from new or worsened disability after surgery. Until now, no measure of disability has been validated in a surgical population.

The team evaluated the psychometric properties of the WHO Disability Assessment Schedule 2.0 (WHODAS) in a diverse cohort of 510 patients up to 12 months after surgery. They found that WHODAS was clinically acceptable, valid, reliable and responsive in this surgical population.

In addition, when combined with survival, WHODAS can be used to measure disability-free survival, providing an outcome measure for future perioperative research and clinical audit that is meaningful to clinicians and patients alike.

Full text journal article link: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2119575