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Journal Title: Minimal clinically important difference in days at home up to 30 days after surgery
Authors: Ferguson, M. T.
Kusre, S.
Myles, P. S.
SWH Author: Kusre, Sandeep
Keywords: Adult
Middle Aged
Minimal Clinically Important Difference
Patient Discharge
Postoperative Care
Postoperative Period
Surveys and Questionnaires
Treatment Outcome
Postoperative Complications
Postoperative Outcomes
Quality Measures
Quality of Recovery
Issue Date: Feb-2022
Date Accessioned: 2023-03-17T04:56:48Z
Date Available: 2023-03-17T04:56:48Z
Accession Number: 34797923
Description Affiliation: Austin Hospital, Melbourne, VIC., Australia.
Warrnambool Base Hospital and Peter MacCallum Cancer Centre, Melbourne, VIC., Australia.
Department of Anaesthesiology and Peri-operative Medicine, Alfred Hospital and Monash University, Melbourne, VIC., Australia.
Monash University, Melbourne, VIC., Australia.
Format Startpage: 196-200
Source Volume: 77
Issue Number: 2
Notes: eng
Anaesthesia. 2022 Feb;77(2):196-200. doi: 10.1111/anae.15623. Epub 2021 Nov 19.
DOI: 10.1111/anae.15623
Date: Feb
Abstract: Patient-centred outcomes are increasingly recognised as crucial measures of healthcare quality. Days alive and at home up to 30 days after surgery (DAH30 ) is a validated and readily obtainable patient-centred outcome measure that integrates much of the peri-operative patient journey. However, the minimal difference in DAH30 that is clinically important to patients is unknown. We designed and administered a 28-item survey to evaluate the minimal clinically important difference in DAH30 among adult patients undergoing inpatient surgery. Patients were approached pre-operatively or within 2 days postoperatively. We did not study patients undergoing day surgery or nursing home residents. Patients ranked their opinions on the importance of discharge home using a Likert scale (from 1, not important at all to 6, extremely important) and the minimum number of extra days at home that would be meaningful using this scale. We recruited 104 patients; the survey was administered pre-operatively to 45 patients and postoperatively to 59 patients. The mean (SD) age was 53.5 (16.5) years, and 51 (49%) patients were male. Patients underwent a broad range of surgery of mainly intermediate (55%) to major (33%) severity. The median minimal clinically important difference for DAH30 was 3 days; this was consistent across a broad range of scenarios, including earlier discharge home, complications delaying hospital discharge and the requirement for admission to a rehabilitation unit. Discharge home earlier than anticipated and discharge home rather than to a rehabilitation facility were both rated as important (median score = 5). Empirical data on the minimal clinically important difference for DAH30 may be useful to determine sample size and to guide the non-inferiority margin for future clinical trials.
Journal Title: Anaesthesia
Type: Journal Article
Appears in Collections:SWH Staff Publications

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