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24-12-2019

What to expect after open heart valve surgery? Changes in health-related quality of life

Auteurs: Britt Borregaard, Susanne S. Pedersen, Selina Kikkenborg Berg, Jordi Dahl, Ola Ekholm, Kirstine Sibilitz, Ann Dorthe Olsen Zwisler, Sandra B. Lauck, Derek Kyte, Melanie Calvert, Lars Peter Schødt Riber, Jacob Eifer Møller

Gepubliceerd in: Quality of Life Research | Uitgave 5/2020

Abstract

Purpose

To (i) describe changes in health-related quality of life (HRQoL) pre-operatively, at discharge, and 4 weeks after discharge following open heart surgery, (ii) compare the performance of the EuroQol Questionnaire (EQ-5D 5L) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) against an anchor-based approach, and to (iii) investigate the association between HRQoL and 180-day readmission.

Methods

A prospective, consecutive cohort (single-center study) of 291 patients completed the EQ-5D 5L and KCCQ pre-operatively, at discharge and 4 weeks post-discharge. Changes in HRQoL over time were evaluated, and the performance of the instruments was investigated. The association between HRQoL and readmission were investigated with Cox Proportional Hazard models.

Results

Scores of the EQ-5D Index and VAS decreased significantly from the pre-operative assessment to discharge and improved from discharge to 4 weeks after. The KCCQ scores significantly improved from baseline to 4 weeks after. Minimal clinically important improvements from before surgery to 4 weeks after were seen among 24% (EQ-5D Index), 45% (EQ-5D VAS), and 57% (KCCQ). More than one-third experienced worse HRQoL 1 month after discharge. Area under the curve (AUC) (performance of the instruments) demonstrated the following: EQ-5D Index AUC 0.622 (95% CI 0.540–0.704), VAS AUC 0.674 (95% CI 0.598–0.750), and KCCQ AUC 0.722 (95% CI 0.65–0.792). None of the HRQoL measurements were associated with 180-day readmission.

Conclusions

This study revealed that HRQoL measured with the EQ-5D is significantly worse at discharge compared to before surgery, but scores increases within the first month measured with the EQ-5D and the KCCQ. The EQ-5D and KCCQ have a moderate correlation with an anchor-based approach but were not associated with readmission.

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Titel: What to expect after open heart valve surgery? Changes in health-related quality of life
Auteurs: Britt Borregaard
Susanne S. Pedersen
Selina Kikkenborg Berg
Jordi Dahl
Ola Ekholm
Kirstine Sibilitz
Ann Dorthe Olsen Zwisler
Sandra B. Lauck
Derek Kyte
Melanie Calvert
Lars Peter Schødt Riber
Jacob Eifer Møller
Publicatiedatum: 24-12-2019
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 5/2020
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-019-02400-9

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