Measuring patient disability in the peri-operative period using the WHODAS 2.0 questionnaire: a systematic review.
Romijn M Boerlage, Daniël van Dartel, Jacqueline E M Vernooij et al.
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In 30 seconds
This systematic review examined how disability measured with the WHODAS 2.0 changes after different types of surgery and how peri-operative disability outcomes are reported. Across 39 studies, pre-operative disability ranged from 2% to 61%, and postoperative patterns varied by procedure. Orthopaedic studies generally found reductions of 10-37% within 3 months, while cancer surgery studies generally reported increases of 1-8% over that period. Reporting was heterogeneous, with multiple disability thresholds, endpoints and assessment time-points, limiting comparisons between studies.
Key findings
- In 21 studies, disability increased by 1% to 17% within 3 months of surgery, with little change between 6 and 12 months (0% to -2%).
- Orthopaedic studies generally reported pre-operative disability above 35% and reductions of 10-37% within 3 months.
- Cancer surgery studies generally reported pre-operative disability below 20% and increases of 1-8% within 3 months.
- Studies used three disability thresholds, 13 WHODAS 2.0 endpoints and eight postoperative assessment time-points.
Why it matters
Disability outcomes can complement procedure-specific measures by describing changes in patients’ everyday functioning. The review suggests that postoperative patterns differ across surgical groups, so pooled or direct comparisons may mislead when studies use inconsistent definitions and assessment schedules. More consistent outcome reporting would make evidence on functional recovery easier to interpret and compare.
What to keep in mind
The review found substantial heterogeneity in disability thresholds, endpoints and postoperative assessment time-points, limiting direct comparison across studies.