Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1627855
Oral Presentations
Sunday, February 18, 2018
DGTHG: Coronary Heart Disease II
Georg Thieme Verlag KG Stuttgart · New York

The Preoperative Physical-health Composite Score is a Good Predictor for Postoperative Morbidity in Elective Cardiac Surgery Patients

B. Hofmann
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
A. Fröhlich
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
S. Richter
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
M. Ehrhardt
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
C. Zitterbart
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
A. Wienke
2   Department of Biostatistics and Informatics, Institute of Medical Epidemiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
,
H. Treede
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
,
A. Simm
1   Department of Cardiac Surgery, University Hospital Halle (Saale), Mid-German Heart Center, Halle, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
22 January 2018 (online)

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Objectives: Health-related quality of life (HRQoL) before elective cardiac surgery has rarely been investigated. We aimed to estimate the preoperative HRQoL and the gait speed, to identify patients with clinically relevant decreases which may have an impact on the postoperative course.

Methods: 148 patients (69.5 ± 9.5 years) scheduled for elective cardiac surgery were enrolled. Based on the HRQoL SF-12 questionnaire, the preoperative physical-health composite score (PCS) and the preoperative mental-health composite score (MCS) were recorded. Also, the preoperative gait speed and several other preoperative variables were evaluated. The outcome parameters were orientated on MACCE and Non-MACCE criteria and the STS outcomes. For the combined categorical outcome postoperative morbidity failure of the cardiac-, pulmonary-, renal- and cerebral-system, as well as deep wound healing disorders were counted for each patient. Patients without or with only one of the outcomes were assigned zero points whereas more than one outcome failure was assigned one point. Univariable and multivariable logistic regression analyses were performed to evaluate the predictive value of PCS, MCS, gait speed and other variables regarding postoperative morbidity.

Results: Preoperative PCS was 40.3 ± 10.2 and preoperative MCS 47.7 ± 8.9 in our patients. The preoperative PCS correlated well with the gait speed of our patients (r = 0.34, p < 0.001). Furthermore, univariable regression analysis identified STS morbidity or mortality (OR = 1.07; 95%CI: 1.005–1.15; p = 0.03), gait speed (OR = 0.16; 95%CI: 0.04–0.74; p = 0.02) and PCS (OR = 0.93; 95%CI: 0.88–0.98; p = 0.005) as predictors of postoperative morbidity. Finally, postoperative morbidity was independently associated with preoperative PCS (OR 0.94; 95%CI: 0.89–0.99; p = 0.03). A preoperative PCS value ≤ 44 (AUROC ± SE, 0.71 ± 0.05; 95%CI: 0.63–0.78; p = 0.0001) predicted postoperative morbidity in these patients.

Conclusion: This study demonstrated for the first time that preoperative physical-health composite score as part of the health-related quality of life assessment is predictive for the postoperative course of cardiac surgery patients.