Validation and clinical utility of the Korean version of the Quality of Recovery-15 with enhanced recovery after surgery: a prospective observational cohort study

Abstract

Background: The 15-item Quality of Recovery (QoR-15) scale is a validated patient-reported outcome questionnaire that measures the quality of postoperative recovery. This study aimed to validate a translated Korean version of QoR-15 (QoR-15K) in a broad range of surgical patients.

Methods: After Korean translation of the original English version of the QoR-15, we performed psychometric validation of the QoR-15K to evaluate the quality of recovery after surgery. The validity, reliability, responsiveness, and clinical feasibility of the QoR-15K were evaluated. A subgroup analysis in patients with video-assisted lung resection was performed.

Results: Among 193 patients, 188 (97.4%) completed the QoR-15K after surgery. We found good convergent validity between the postoperative QoR-15K and the global QoR visual analogue scale (ρ=0.61, P<0.001). The negative correlation between the QoR-15K score and the extent of surgery (ρ=-0.33, P<0.001), the duration of surgery (ρ=-0.33, P<0.001), and the severity of postoperative pain (ρ=-0.40, P<0.001) supported construct validity. The postoperative QoR-15K showed good internal consistency (Cronbach α=0.90), split-half reliability (0.81), and test-retest reliability (0.95; 95% confidence interval [CI], 0.94-0.96). The QoR-15K score decreased from 140 (preoperative, inter-quartile range [IQR] 128-146) to 100 (postoperative day 1, IQR 75-122), median difference -36.5 (95% CI, -41 to -32.5; P<0.0001). The QoR-15K indicated excellent responsiveness with Cliff's effect size -0.78 (95% CI, -0.84 to -0.71). Subgroup analysis yielded similar results.

Conclusions: The QoR-15K is valid and has excellent reliability, a high degree of responsiveness, and clinical feasibility as a metric of quality of recovery in Korean surgical population.

Clinical trial registration: NCT04169087.

Keywords: enhanced recovery after surgery; patient outcome assessment; patient-reported outcome measures; perioperative medicine; quality of recovery.