Does Cardiac Surgery Affect Quality of Life? An Update of More than 200 Patients

Objectives: Improved quality of life is one of the most important tasks of cardiac surgery. But as patient population becomes older, severe comorbidities are no curiosity. Patients older than 80 years are common and belong to daily routine. Although improving quality of life is such an important goal of cardiac surgery, there are only a few studies on this topic and most of them are retrospectively.

Methods: This is a prospective study with two measurements using three different questionnaires before and 1 year after cardiac surgery. Used questionnaires are SF-36, EQ-5D and Time-trade-off. 496 patients who underwent cardiac surgery at our hospital between March and December 2013 are included. So far, 1-year follow-up data of 340 patients are available and analyzed. A total of 140 patients underwent coronary artery bypass surgery (83 on-pump and 57 off-pump), 78 patients had an aortic valve replacement (50 conventional, 28 interventional), and 36 patients had a mitral valve intervention (31 times mitral valve repair, 5 mitral valve replacement). Rest of the patients had combined or different interventions. The mean age of the patient population was 68.4 (range: 24–95 years), 228 were males, 112 females.

Results: Regarding the results of the EQ-5D questionnaire all patients had a significant improvement in the dimensions mobility (p < 0.0001), usual activities (p < 0.0001), pain/discomfort (p < 0.0001), anxiety/depression (p = 0.0433) and general health state (p < 0.0001), 1 year after cardiac surgery. Also the Time-trade-off showed a significant improvement of life quality (p < 0.0001). Similar to these results we observed a significant improvement of five of the eight subsections (physical functioning (p < 0.0001), role limitations due to physical health (p < 0.0001), pain (p < 0.0001), emotional well-being (p = 0.0028) and role limitations due to emotional problems (p < 0.0001) of the SF-36. Comparable to our further data we observed impairments in the subsections “general health” (p < 0.0001) and “energy/fatigue” (p = 0.0021). Patients older than 75 years had a similar benefit of cardiac surgery in comparison to younger ones.

Conclusion: The majority of the patients had a significant benefit from cardiac surgery one year after operation. Also elderly patients profit due to a clear improvement of health-related quality of life. SF-36 is by far the most differentiated questionnaire but in many cases too complex for clinical routine.