Recovery Patterns: Longitudinal Cluster Analysis of Physical Function Following Abdominal Surgery.

BACKGROUND

A rise in the proportion of day surgery has seen a concomitant increase in the proportion of patients recovering at home. Blended eHealth is well situated to provide this group with medical support and supervision. However, a data-driven description of the heterogeneity is missing.

OBJECTIVE

To identify clinically meaningful patterns of functional recovery following abdominal surgery and describe how the emergent patient characteristics differ between them.

METHODS

This was a secondary data analysis of 2 data sets collected through 2 previously conducted RCTs. We used k-medoids clustering and growth mixture modeling on the longitudinal patient-reported outcome measurement information system physical function t-scores of 649 patients. Differences in patient characteristics between the resultant clusters were identified through statistical tests.

RESULTS

Three clusters-fast, intermediate, and uneven recovery-were identified regardless of the data set or statistical technique. A fourth cluster-relapse-was identified by both statistical techniques but only in the presence of heavy surgery. The fifth and sixth clusters-low gain and high gain-were identified for both light and heavy surgery, but only through k-medoids clustering.

CONCLUSIONS

Trajectories of physical function following abdominal surgery are heterogenous but distinct clinically meaningful patterns can be extracted. This classification may facilitate shared decision-making during preoperative care, and future research may utilize them as targets for prediction.