Key result
Higher pre-operative Physical (56.6 vs 40.7) and Mental (65.2 vs 45.8) Component Summary scores were associated with a lack of quality of life improvement 1 year after cardiac surgery (P<0.001).
Why the study?
Does elective on-pump cardiac surgery improve health-related quality of life in patients undergoing elective on-pump cardiac surgery?
Cohort
Does elective on-pump cardiac surgery improve health-related quality of life in patients undergoing elective on-pump cardiac surgery?
p-value: p=<0.001
Patients with higher pre-operative physical and mental quality of life scores are less likely to experience long-term HRQOL improvements one year after elective on-pump cardiac surgery.
High preoperative HRQOL scores warrant caution in expecting gains; leaves open prospective validation before guiding selection.
BACKGROUND: Long-term improvement in health-related quality of life (HRQOL) is one of the most important outcomes of cardiac surgery. The aim of this study is to define the impact of perioperative patient and procedural variables on HRQOL dynamics, a year after cardiac surgery. METHODS: Consecutive patients undergoing elective on-pump cardiac surgery were enrolled in this prospective observational cohort study. Patients completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire a day before surgery and once again a year after surgery. The effect size method was used to determine whether treatment resulted in the improvement of HRQOL. RESULTS: A total of 67.3% of patients achieved long-term improvement in HRQOL. Significant negative association was identified between Physical and Mental Component Summary scores (PCS/MCS) and long-term outcomes. Pre-operative PCS were 40.7 ± 13.7 for improvers and 56.6 ± 14.4 for non-improvers; MCS were 45.8 ± 12.1 and 65.2 ± 13.7, respectively (P < 0.001 for all). There were no statistically significant differences in pre-operative risk factors, demographics, operative factors or post-operative variables between the two groups. CONCLUSION: Among those completing this study, one in three patients did not experience long-term HRQOL improvements following cardiac surgery. Multivariate analysis confirmed that higher pre-operative PCS and MCS are independent predictors of worse HRQOL a year after surgery. Further research should focus on establishing the prevalence of this phenomenon worldwide and develop targeted interventions to improve long-term self-perceived quality of life for patients with relatively good pre-operative health.
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Norkienė et al. (2017) conducted a cohort in Elective on-pump cardiac surgery. Higher pre-operative Physical and Mental Component Summary (PCS/MCS) scores vs. Lower pre-operative PCS/MCS scores was evaluated on Long-term improvement in health-related quality of life (HRQOL) (p=<0.001). Higher pre-operative Physical (56.6 vs 40.7) and Mental (65.2 vs 45.8) Component Summary scores were associated with a lack of quality of life improvement 1 year after cardiac surgery (P<0.001).
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