J.X. Xu1,2, J.D. Peipert1, V. Rohan1, D. Ladner1, Z. Dietch1 1Feinberg School Of Medicine – Northwestern University, Comprehensive Transplant Center, Chicago, IL, USA 2Massachusetts Institute Of Technology, Cambridge, MA, USA
Introduction:
Patient-reported outcome measures (PROMs) have been increasingly utilized to assess patient well-being and outcomes of interest without interpretation from others. While ample literature has used PROMs to evaluate surgical procedure effectiveness and predict postoperative patient-reported outcomes (PROs), few studies have used PROMs to predict postoperative complications. There are no known reviews on the use of PROMs to predict postoperative complications, prompting current research. The goal of this study is to provide a scoping review from existing literature on the use of PROMs to predict postoperative outcomes.
Methods:
A search was conducted on PubMed using the search term: ("Patient Reported Outcome Measures"[Mesh] OR patient reported outcome*[tiab]) AND (predict*[tiab] OR correlate*[tiab]) AND ("Postoperative Complications"[Mesh] OR postoperative complication*[tiab] OR Secondary surg*[tiab] OR "Patient Readmission"[Mesh] OR "Reoperation"[Mesh]) AND (Surg*[tiab] OR transplant*[tiab]). This term includes keywords for PROs, prediction, postoperative complications, and surgery. Title and abstract screening included studies which strictly used PROMs to predict complications after surgery. Upon full-text review, studies about surgery or complications predicting PROs and PROMs predicting factors including surgery quality and patient satisfaction were excluded.
Results:
The initial search returned 500 studies. After screening, 16 studies were selected. 14 out of 16 studies found that PROMs significantly predict risk or incidence of postoperative complications. Of these 14 studies, all studies used preoperative PROs to predict postoperative complications, 10 studies assessed PROs postoperatively, and one assessed PROs at discharge. Most predictions are based on disease and condition-specific PROMs. Six studies measured PROs in orthopedic surgeries, with other subspecialties represented being oncology, colorectal, thoracic, and neurosurgery.
Conclusion:
PROMs have been successfully used in a small number of studies to predict postoperative complications. Identifying patients with increased risk for complications can inform which patients would benefit from preventative interventions. This demonstrates potential to integrate PROMs into clinical workflows. Due to a small number of surgical subspecialties represented in selected studies, further research is merited in unrepresented subspecialties to determine whether PROMs have utility in predicting postoperative complications.