Patient-reported symptoms at discharge and risk of complications after gynecologic surgery

Objective Current gaps in knowledge limit clinicians from fully implementing patient-reported outcomes in routine post-operative care. Methods This prospective study assessed symptoms via the gynecologic module of the MD Anderson Symptom Inventory (MDASI-PeriOp-GYN) in patients who underwent open laparotomy. Results At discharge, patient-reported moderate to severe (≥4 on a 0-10 scale) abdominal bloating or abdominal cramping, combined with length of stay of ≥4 days, were found to be associated with a higher risk of 30-day post-operative grade II-IV complications by the Clavien-Dindo system (all p values <0.01). Also, length of stay of ≥4 days and moderate to severe urinary urgency at discharge were found to be associated with the need for re-admission (all p values <0.01). Conclusion This study defined the clinically meaningful symptoms that related to the risk of developing important complications after discharge from major open gynecological surgery. These findings support the integration of assessment of patient-reported outcomes into patient-centered post-operative care.