Recovery patterns and health-related quality of life in older patients undergoing cardiac surgery: a prospective study

Eur J Cardiovasc Nurs. 2012 Sep;11(3):322-30. doi: 10.1016/j.ejcnurse.2011.05.002. Epub 2012 Apr 4.

Abstract

Background: Health-related quality of life (HRQOL) is an important endpoint following cardiac surgery. Particularly in older age, HRQOL, rather than longevity, is the primary goal of treatment. However, prospective studies describing recovery and HRQOL are still scarce.

Aims: To explore recovery patterns and HRQOL in patients undergoing cardiac surgery, emphasizing older patients ≥75 years of age.

Methods: In a prospective population-based study, 534 patients (23% ≥75 years) were consecutively included before surgery. HRQOL, medical and socio-demographic variables were measured by questionnaires at baseline, 6 and 12 months after surgery. HRQOL was measured by the short-form health survey (SF-36).

Results: Five hundred and twenty patients were alive 12 months after surgery, 89% responded after 6 and 12 months. Older patients as well as younger patients had a clear overall improvement in HRQOL over the first year after cardiac surgery, more specifically during the first 6 months. The same pattern was found in self-reported NYHA class which improved from baseline to 6 months and stabilized between 6 and 12 months. The only SF-36 scale with different development was Role Physical where younger patients improved more than older patients. Before surgery, patients had substantially lower scores than the population norms. However, on most dimensions of HRQOL older patients reached the level of the norm population after surgery.

Conclusion: A selected group of elderly patients can undergo cardiac surgery with excellent results concerning survival and HRQOL. This is of major importance both discussing health care resources and decision making concerning individual patients.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cardiac Surgical Procedures / psychology*
  • Convalescence / psychology*
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*