Assessing the recovery after cardiac surgery: Development and validation of the Fuwai-CRS (Fuwai-Cardiac Recovery Scale)

Abstract Background Cardiac surgery significantly improves clinical endpoints but imposes challenges in postoperative recovery. Assessing patient-reported outcome is crucial for optimal care. However, no cardiac surgery-specific tools currently exist to adequately capture postoperative recovery experience. Objectives To develop and validate a recovery scale after cardiac surgery (Fuwai-CRS). Methods This study was conducted from May 2023 to December 2024, comprising: (1) a qualitative study (Cohort 1) enrolling postoperative patients of cardiac surgery and medical staffs to develop the draft scale through literature review, semi-structured interview and Delphi consensus; and (2) a single-center prospective validation study (Cohort 2) to finalize the scale and evaluate psychometric properties. Results In Cohort 1, a 17-item draft Fuwai-CRS was generated based on literature review, semi-structured interview (40 patients and medical staffs) and a Delphi study (15 experts). In Cohort 2 (n=500), a 9-item Fuwai-CRS was finalized by data distribution assessment, hierarchical cluster and factor analysis, and its understandability, reliability, validity and responsiveness were found acceptable. Conclusions The Fuwai-CRS is a concise and valid tool for recovery assessment after cardiac surgery.