Abstract
Background With increasing importance, health-related quality of life (HRQoL) has become a crucial
outcome measure of cardiac surgery. The aim of this study was to assess the dynamics
of HRQoL change within 12 months after surgery and to identify predictors of deterioration
in physical and mental health.
Methods The cohort of this prospective study included 164 consecutive patients who underwent
elective surgery. HRQoL was assessed on the basis of the Short-Form 36 questionnaire
at three different times: upon admission and at 3 and 12 months after surgery. The
minimal clinically important difference (MCID) was used to determine whether the surgery
resulted in deterioration of HRQoL.
Results In general, physical and mental health status improved within the first year after
cardiac surgery. However, after 12 months, 7.9 and 21.2% of patients had clinically
significant poorer physical (PCS) and mental component summary (MCS) scores, based
on the MCID approach. The results of multivariate analysis identified preoperative
health status, age < 70 years, coronary artery bypass grafting, and a previous neurological
event as predictors of deterioration in postoperative HRQoL. The greatest risks for
deterioration were higher preoperative PCS and MCS scores.
Conclusion Although we were able to demonstrate a general improvement in the HRQoL following
cardiac surgery, in one-fifth of patients, there was no recovery of mental health
status even after 1 year. As this effect is mainly determined by preoperative functional
status, HRQoL should be an integral part of medical consultation, especially in younger
patients with a positive perception of quality of life.
Keywords
Outcomes - includes mortality - morbidity - quality of life - cardiac - coronary artery
bypass grafting - CABG
