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CC BY-NC-ND 4.0 · Aorta (Stamford) 2024; 12(03): 050-059
DOI: 10.1055/s-0045-1802991
Original Research Article

Quality of Life after Type A Aortic Dissection Surgery in the United Kingdom: The QUADS Study

Brianda Ripoll 
1   Leeds General Infirmary, Leeds, United Kingdom
,
Adeyemi Olayiwola
2   St Bartholomew's Hospital, London, United Kingdom
,
Sanjeev Kalra
3   The Freeman Hospital, Newcastle, United Kingdom
,
Aidil Syed
4   University Hospital of Wales, Cardiff, United Kingdom
,
Massimo Capoccia
5   Castle Hill Hospital, Hull, United Kingdom
,
Shaheen Ahmed
3   The Freeman Hospital, Newcastle, United Kingdom
,
Marinos Koulouroudias
6   Nottingham City Hospital, Nottingham, United Kingdom
,
Ioan Mocanu
7   Golden Jubilee Hospital, Glasgow, United Kingdom
,
Stephen Clark
3   The Freeman Hospital, Newcastle, United Kingdom
,
Indu Deglurkar
4   University Hospital of Wales, Cardiff, United Kingdom
,
Walid Elmahdy
1   Leeds General Infirmary, Leeds, United Kingdom
,
Jonathan Hyde
8   Royal Sussex County Hospital, Brighton, United Kingdom
,
Niki Nicou
6   Nottingham City Hospital, Nottingham, United Kingdom
,
Nawar Al Attar
7   Golden Jubilee Hospital, Glasgow, United Kingdom
,
Alexander Cale
5   Castle Hill Hospital, Hull, United Kingdom
,
Mahmoud Loubani
5   Castle Hill Hospital, Hull, United Kingdom
,
Aung Ye Oo
2   St Bartholomew's Hospital, London, United Kingdom
,
Ana Lopez-Marco
2   St Bartholomew's Hospital, London, United Kingdom
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Abstract

Background Acute Type A aortic dissection (TAAD) is a life-threatening condition that carries significant mortality and morbidity; a proportion of the survivors might require further aortic procedures in the mid-/long-term follow-up. Quality of life (QoL) after TAAD is not well studied. Quality of life after Type A Aortic Dissection Surgery (QUADS) is the first multicentre study to assess QoL in survivors of surgically treated TAAD.

Methods A tailored questionnaire for survivors of TAAD was designed with patient and public involvement. Patients who underwent surgery from 2018 to 2022 in eight United Kingdom centres were invited to participate. Preoperative, intraoperative, and postoperative prospectively collected data were collated and analyzed retrospectively. The data were analyzed with SPSS v29. Patient's questionnaire was validated with a Cronbach's alpha analysis, exploratory factor analysis, and AMOS confirmatory factor analysis. Three groups were created according to QoL (Good, Fair, Poor).

Results A total of 162 patients were recruited. Majority were male with a mean age of 63 years (24–92). Surgical procedures for TAAD were root and ascending aorta replacement (n = 61, 38%), ascending (n = 81, 50%), and/or arch replacement (n = 20, 12%). Eleven patients (7%) required later intervention. Patient's answers regarding overall QoL were good (n = 67, 41%), fair (n = 89, 55%), and poor (n = 6, 4%). Neurological complications, circulatory arrest duration, reoperation for bleeding, postoperative myocardial infraction, arrhythmias, wound infection, and patient destination at discharge have been identified as main variables impacting on QoL after TAAD surgery across different domains of this questionnaire.

Conclusion QUADS questionnaire is the first tailored and validated questionnaire for TAAD survivors. Results in the United Kingdom population suggest that it is a useful tool to assess QoL after TAAD surgery.

Keywords

Type A aortic dissection - quality of life - aortic surgery - reintervention - multicenter study

Authors' Contribution

B.R.: chief investigator, data and statistical analysis, manuscript writing. W.E., M.L., A.Y.O., A.L.M.: project supervision, data interpretation, manuscript edition. A.O., S.K., A.S., M.C., S.A., M.K., I.M., S.C., I.D., W.E., J.H., N.N., N.A., A.C.: local principal investigator and data collectors.


Supplementary Material



Publication History

Received: 07 May 2024

Accepted: 06 November 2024

Article published online:
25 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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