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OBJECTIVE: Innovations in surgery are advocated on the basis of “enhanced recovery”. Recovery is a complex process encompassing multiple domains including symptoms and emotional, social, economic and physical function. Individual aspects of recovery are currently measured using narrowly focused administrative indicators(length of stay) or patient-reported multiple-item questionnaires (eg.quality of life). Questionnaire length and the difficulty of integrating these different view points limit accurate measurement. The objective of our study was to integrate multiple instruments used to estimate recovery into a single quantitative measure that would be sensitive to expected differences in recovery after abdominal surgery. METHODS: The measure was developed and validated using data from patients undergoing scheduled abdominal surgery. Patients were interviewed preoperatively, 3weeks and 2months postop using 93 items from 5 indices currently used to assess domains of recovery: health-related quality-of-life(SF-36), Quality of Recovery score(QoR), symptoms(visual analog scale), physical activity(CHAMPS questionnaire) and general health perception(EQ-5D). Rasch analysis combined items across domains of the various instruments to develop the new measure on a logit scale which was transformed to a score from 0-100(SD). Longitudinal, known-groups convergent and convergent construct validity were assessed to demonstrate the psychometric properties of the new measure. *p<0.01, †p<0.05.RESULTS: Data from 177 patients, 67% male with mean age 55(15) were collected. 61% underwent ambulatory surgery while 39% were admitted. 20% developed at least one complication. A 24-item measure met all model requirements and included items from various domains. Reliability was excellent(0.88). Mean score returned to baseline from 69(13) preop to 67(14) at 3weeks and increased above baseline to 76(14) at 2months*. Compared to patients undergoing higher intensity procedures requiring admission, ambulatory patients had faster recovery, returning to preop scores at 3weeks(72vs70†) and increasing above baseline at 2months(81vs70*). Scores for inpatients were decreased at 3weeks(58vs67†) but returned to baseline at 2months(69vs67). Ambulatory patients had higher scores postoperatively at 3weeks(72vs58*) and 2months(81vs68*). Patients who developed complications had lower scores preoperatively(64vs70†), at 3 weeks(60vs71*) and 2 months(66vs78*). The measure had moderate correlations with all instruments (r=0.3-0.8*).CONCLUSIONS: A novel measure of recovery after abdominal surgery was developed encompassing a broad range of domains. Results are compatible with clinically observed postoperative recovery trajectories. This method illustrates that recovery can be quantified with mathematical units.