Patients who dropped out of quality of life evaluations one year post cardiac surgery had significantly lower preoperative quality of life, were older, and had higher operative risk compared to those with complete follow-up.
Observational (n=1,675)
No
Are post-cardiac surgery quality of life assessments biased by drop-outs among older, high-risk patients?
Quality of life post cardiac surgery is likely overestimated because older, high-risk patients with low preoperative QoL are more likely to drop out of follow-up assessments.
Absolute Event Rate: 0.65% vs 0.74%
p-value: p=0.001
BACKGROUND: Quality of Life (QoL) studies concerns the difference in QoL between the baseline and the post-surgical assessment. Many such studies, however, suffer from incomplete QoL-data with regard to patients with a proven survival--the drop-outs. Our hypothesis is that patients with a low preoperative QoL, high operative risk and older age are at higher risk for drop-out, which may result in a biased conclusion. METHODS: This study includes 1675 patients, all of whom were operated between July 1, 2009 and July 1,2012 and have a proven one-year survival, as well as a complete preoperative EuroQoL registration (EQ-5D and EQ-VAS). Based on the calculated 30 and 70 percentiles of age, EuroSCORE risk, and EQ-5D and EQ-VAS values, the group was split into three different subgroups. We studied whether (1) there was a correlation between age, risk, preoperative QoL and postoperative QoL and (2) if the drop-outs were correlated to age, risk and preoperative QoL. RESULTS: There is a statistically significant correlation between postoperative QoL and both age (p = 0.029) and risk (p = 0.002). Both relations have a negative Pearson's r. There is also a statistically significant (p = 0.0001) correlation between pre- and postoperative QoL, now with a positive Pearson's r. The percentage of drop-outs increases in a statistically significant manner with an increased risk (p = 0.001), older age (p = 0.001) and a low preoperative QoL (EQ-5D, p = 0.001 and EQ-VAS, p = 0.003). CONCLUSION: We conclude that QoL post cardiac surgery is overestimated, certainly for older, high risk patients and patients with a low preoperative QoL.
L. Noyez (2014) conducted an observational in Post cardiac surgery (n=1,675). Drop-outs (incomplete postoperative QoL) vs. Complete postoperative QoL follow-up was evaluated on Preoperative EQ-5D score (p=0.001). Patients who dropped out of quality of life evaluations one year post cardiac surgery had significantly lower preoperative quality of life, were older, and had higher operative risk compared to those with complete follow-up.
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