What to expect after open heart valve surgery? Changes in health-related quality of life

Purpose To (i) describe changes in health-related quality of life (HRQoL) pre-operatively, at discharge, and 4 weeks after discharge following open heart surgery, (ii) compare the performance of the EuroQol Questionnaire (EQ-5D 5L) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) against an a...

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Published in:Quality of life research 2020-05, Vol.29 (5), p.1247-1258
Main Authors: Borregaard, Britt, Pedersen, Susanne S., Berg, Selina Kikkenborg, Dahl, Jordi, Ekholm, Ola, Sibilitz, Kirstine, Zwisler, Ann Dorthe Olsen, Lauck, Sandra B., Kyte, Derek, Calvert, Melanie, Riber, Lars Peter Schødt, Møller, Jacob Eifer
Format: Article
Language:English
Subjects:
Aged
Cardiac Surgical Procedures - psychology
Cardiac Surgical Procedures - rehabilitation
Cohort Studies
Female
Heart Valves - surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Patient Discharge
Prospective Studies
Public Health
Quality of life
Quality of Life - psychology
Quality of Life Research
Questionnaires
Sociology
Surgery
Surveys and Questionnaires
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Summary:Purpose To (i) describe changes in health-related quality of life (HRQoL) pre-operatively, at discharge, and 4 weeks after discharge following open heart surgery, (ii) compare the performance of the EuroQol Questionnaire (EQ-5D 5L) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) against an anchor-based approach, and to (iii) investigate the association between HRQoL and 180-day readmission. Methods A prospective, consecutive cohort (single-center study) of 291 patients completed the EQ-5D 5L and KCCQ pre-operatively, at discharge and 4 weeks post-discharge. Changes in HRQoL over time were evaluated, and the performance of the instruments was investigated. The association between HRQoL and readmission were investigated with Cox Proportional Hazard models. Results Scores of the EQ-5D Index and VAS decreased significantly from the pre-operative assessment to discharge and improved from discharge to 4 weeks after. The KCCQ scores significantly improved from baseline to 4 weeks after. Minimal clinically important improvements from before surgery to 4 weeks after were seen among 24% (EQ-5D Index), 45% (EQ-5D VAS), and 57% (KCCQ). More than one-third experienced worse HRQoL 1 month after discharge. Area under the curve (AUC) (performance of the instruments) demonstrated the following: EQ-5D Index AUC 0.622 (95% CI 0.540–0.704), VAS AUC 0.674 (95% CI 0.598–0.750), and KCCQ AUC 0.722 (95% CI 0.65–0.792). None of the HRQoL measurements were associated with 180-day readmission. Conclusions This study revealed that HRQoL measured with the EQ-5D is significantly worse at discharge compared to before surgery, but scores increases within the first month measured with the EQ-5D and the KCCQ. The EQ-5D and KCCQ have a moderate correlation with an anchor-based approach but were not associated with readmission.
ISSN:0962-9343
1573-2649
DOI:10.1007/s11136-019-02400-9