August 28 Presentation Recap: Patient-Centered Recovery Scale in Cardiac Surgery
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Collaborative work between Maryland and Virginia cardiac surgery quality initiatives shows that traditional mortality measures may tell only part of the story
On August 28, VCSQI and the Maryland Cardiac Surgery Quality Initiative (MCSQI) hosted a special collaborative presentation featuring Dr. Hanghang Wang of Johns Hopkins University on the Patient-Centered Recovery Scale (PCRS).
PCRS was developed to provide a broader assessment of postoperative recovery than mortality alone. The scale classifies recovery using four domains available within existing registry data: ICU length of stay, discharge disposition, postoperative complications, and 30-day readmissions. The overall recovery category is determined by the most severe domain experienced by the patient.
Using more than 33,000 MCSQI patients, investigators found that fewer than one-third achieved optimal recovery, nearly half experienced minor setbacks, and approximately one in five experienced poor recovery, despite operative mortality of less than 3%. PCRS also demonstrated meaningful associations with long-term survival, healthcare utilization, and cost.
Importantly, validation within the VCSQI population produced similar recovery distributions, procedure-level patterns, cost gradients, and hospital variability without modification of the scale. Hospital-level poor recovery was also not correlated with STS mortality observed-to-expected performance, suggesting that PCRS may capture an additional dimension of quality not reflected in traditional mortality-based benchmarking.
Patient interviews further supported the clinical relevance of the measure, with priorities such as avoiding major complications, maintaining independence, avoiding readmission, minimizing ICU stay, and returning home closely aligning with the PCRS domains.
The presentation highlighted the potential role of PCRS as a complementary measure for quality improvement, benchmarking, shared decision-making, and future recovery-management dashboards.
Watch the August 28 presentation:
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