Original article
Adult cardiac
Improvements in Health-Related Quality of Life Before and After Isolated Cardiac Operations

https://doi.org/10.1016/j.athoracsur.2010.11.015Get rights and content

Background

Our study compared health-related quality of life (HRQOL) among cardiac surgical patient groups before and after cardiac operations for isolated surgical procedures and examined cardiac surgical patient HRQOL within the context of United States population norms.

Methods

Of 2524 patients undergoing cardiac operations, 370 underwent isolated procedures (coronary artery bypass grafting, 136; aortic valve repair or replacement, 96; mitral valve repair or replacement, 92; Maze procedures, 46) between April 18, 2004, and June 30, 2008. They completed Short Form 36 questionnaires at baseline, at 3, 6, and 12 months postoperatively, and annually thereafter. Statistical analyses included χ2, analysis of variance, longitudinal modeling, and longitudinal multivariable analyses.

Results

Overall, the 370 cardiac surgical patients were 61.5 ± 11.9 years old, 70% men, and 76% white. Significant baseline differences in HRQOL existed among the cardiac surgical groups. Physical and mental components of the Short Form 36 improved from baseline to within 3 to 6 months postoperatively and remained stable through 3 years for all groups. When demographic and clinical covariates were held constant, the effect of cardiac surgical type on postsurgical HRQOL changes was not significant.

Conclusions

HRQOL improves early after cardiac operations and remains relatively constant long-term, independently of procedure type.

Section snippets

Material and Methods

This single-site prospective, longitudinal observational study was approved by our Institutional Review Board.

Demographic, Behavioral, and Clinical Baseline Characteristics

Overall, the 370 patients who underwent isolated cardiac surgical procedures were 61.5 ± 11.9 years old, 70% men, and 76% white. Significant differences in demographic, behavioral, and clinical characteristics were identified among groups (Table 2).

Baseline

There were significant baseline differences in HRQOL among the isolated cardiac surgical groups. MV patients had better mean PCS scores at baseline compared with AV, CAB, and Maze patients (51.4 vs 44.5 vs 43.1 vs 43.2, respectively; p < 0.001). Maze

Comment

For all isolated cardiac operations, HRQOL improves from baseline to 3 or 6 months postoperatively and is generally maintained through year 3. When demographic and clinical variables are held constant, the type of cardiac operation does not influence postsurgical HRQOL changes across time. Our findings indicate that patients return to levels of HRQOL expected for the U.S. general population after cardiac operations.

The poor baseline physical HRQOL and subsequent postoperative improvement for

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