eP630 - Expectations for Recovery Among Older Patients Undergoing Major Abdominal Surgery

Purpose/Background: Older adults represent a growing proportion of the surgical population and there is an increasing emphasis on improving patient reported outcomes. A patient’s expectations for postoperative recovery can influence their experience which in turn can reflect in their reported outcomes. Little is known about older adults’ expectations for recovery after major abdominal surgery. We aimed to describe the experience of older adults recovering from surgery, seeking to better understand experiences that did not meet patient expectations.Methods/Interventions: This is a preliminary analysis of a single center qualitative study of adults who underwent major abdominal surgery. We included English-speaking patients ≥65 years with ASA class ≥3 who were hospitalized ≥3 days following surgery for benign or malignant disease. Patients were interviewed within 4 months after their surgery. Interviews were transcribed, and a qualitative inductive content analysis was conducted to identify themes related to expectations for surgical recovery.Results/Outcomes: To date, we have interviewed 19 patients. The mean age was 72 years and 42% were female. 47% (9/19) of participants reported that recovery was worse than expected, 26.5% (5/19) reported recovery was better than expected, and 26.5% (5/19) said recovery was as expected. Among patients whose recovery was worse than expected, themes included eating difficulties, prolonged weakness, and the intensity of care required during recovery. Patients described unexpected impacts of surgery or anesthesia on their ability to eat. For example, one patient stated, “[Surgeon] let me know everything that could possibly happen except for the part about not being able to eat. And that was a surprise… every food tasted really, really bitter” Another patient said, “I couldn't stand food for about two or three weeks. I had to eat but it was just a real-- I was forcing myself.” Another common theme was weakness after surgery, which often lasted longer than expected. As one participant stated, “I don't know how typical it is but I was really amazed at how long it took me to get my strength back…I'm in PT and I'm in OT twice a week. And you know, I was just, I'm still amazed at how out of shape I was.” A final theme was surprise at the intensity of care required during recovery, which was often due to unexpected complications. For example, one participant stated, “I was in SICU for a week. And then it was like I had 15 or 16 people in my room and then another 15 out the hall. Radiologists every which way. I'm like, I didn't know what was going on. That was not expected.” Another participant stated, “Seems like every time I got on top of things, I had a setback. And I had a couple of them. I've been in the hospital three times.”Conclusion/

Discussion: This preliminary analysis demonstrates that recovery was more difficult than expected for nearly half of older adults undergoing major abdominal surgery. Themes identified included difficulty eating, prolonged weakness, and the need for greater than expected intensity of treatment. We will continue enrollment to reach thematic saturation, ultimately improving our understanding of patient expectations after surgery and identifying opportunities to improve patient reported outcomes.