The Surgical Recovery Score correlates with the development of complications following elective colectomy.

Abstract

BACKGROUND: The Surgical Recovery Score (SRS) is a validated, comprehensive recovery assessment tool used to measure functional recovery after major surgery. To further evaluate its clinical applicability, this study investigated whether the SRS correlates with clinical outcomes and the occurrence of complications after elective colectomy. MATERIALS AND METHODS: We conducted a retrospective review of prospectively collected data for consecutive patients undergoing elective colonic resection within an enhanced recovery program at our institution from September 2008 to September 2011. We administered the 31-item SRS questionnaire preoperatively (baseline) and on postoperative days 1, 3, 7, 14, and 30. We scored individual questionnaires as a percentage of the maximum possible score, with a higher SRS indicating improved functional recovery (range, 17-100). We prospectively recorded clinical outcomes and graded 30-d complications as per the Clavien-Dindo classification. We conducted univariate and logistic regression analysis to determine the correlation of the SRS to the development of complications. RESULTS: We evaluated 134 patients, 62 of whom developed minor complications (grades 1-2) (46%) and 21 of whom developed major complications (grades 3-5) (16%). The SRS was similar at baseline in the complicated and uncomplicated groups but significantly lower on postoperative days 3, 7, 14, and 30 in patients who developed major complications, and on days 7 and 14 in patients who developed minor complications. In a logistic regression analysis, the SRS on postoperative day 3 was independently associated with the development of any complication, as well as major complications specifically. CONCLUSIONS: In addition to measuring functional recovery, the SRS closely correlates with the development of complications after elective colectomy and offers a reliable outcome measure to assess overall postoperative recovery.