C Olsson1, S Thelin. 1. Department of Cardiothoracic Surgery, Uppsala University Hospital, Sweden.
Abstract
BACKGROUND: The results of surgical repair of thoracic aortic lesions are improving. Still, mortality and morbidity are considerable. Outcomes need to be studied in greater detail. We studied quality of life in survivors of thoracic aortic surgery, which has not been reported before. METHODS: During a 5-year period, 115 patients underwent thoracic aortic repair. All mid- to long-term survivors (n = 81; median follow-up time, 26 months) received the Short Form-36 (SF-36) health questionnaire plus specific questions related to surgery. Five patients were lost to follow-up. RESULTS: Scores for the eight dimensions of SF-36 (range, 0 to 100, 100 reflecting best function) were compared with a normal population. The mean deficits from the norm were bodily pain, 0.1 (95% confidence interval, -3.4 to 3.6) points below norm; mental health, 8.3 (5.7 to 10.9); vitality, 9.5 (6.7 to 12.3); social functioning, 10.1 (6.9 to 13.3); general health, 11.1 (8.5 to 13.7); physical functioning, 16.6 (13.4 to 19.8); role emotional, 20.6 (15.3 to 25.9); and role physical, 30.2 (24.7 to 35.7). Subgroup scores for acute versus elective cases, ascendens versus arch versus descendens procedures, and major complication versus no major complication were not significantly different. Sixty-six percent (50 of 76) stated a general health perception improvement. In 82% (62 of 76), the quality of life improved or was preserved. Ninety-one percent (69 of 76) considered the operation successful. CONCLUSIONS: Considering the seriousness of the conditions, quality-of-life scores after thoracic aortic surgery were acceptable, although lower than in a normal population, except for bodily pain. Postoperative quality of life justifies thoracic aortic surgical repair.
BACKGROUND: The results of surgical repair of thoracic aortic lesions are improving. Still, mortality and morbidity are considerable. Outcomes need to be studied in greater detail. We studied quality of life in survivors of thoracic aortic surgery, which has not been reported before. METHODS: During a 5-year period, 115 patients underwent thoracic aortic repair. All mid- to long-term survivors (n = 81; median follow-up time, 26 months) received the Short Form-36 (SF-36) health questionnaire plus specific questions related to surgery. Five patients were lost to follow-up. RESULTS: Scores for the eight dimensions of SF-36 (range, 0 to 100, 100 reflecting best function) were compared with a normal population. The mean deficits from the norm were bodily pain, 0.1 (95% confidence interval, -3.4 to 3.6) points below norm; mental health, 8.3 (5.7 to 10.9); vitality, 9.5 (6.7 to 12.3); social functioning, 10.1 (6.9 to 13.3); general health, 11.1 (8.5 to 13.7); physical functioning, 16.6 (13.4 to 19.8); role emotional, 20.6 (15.3 to 25.9); and role physical, 30.2 (24.7 to 35.7). Subgroup scores for acute versus elective cases, ascendens versus arch versus descendens procedures, and major complication versus no major complication were not significantly different. Sixty-six percent (50 of 76) stated a general health perception improvement. In 82% (62 of 76), the quality of life improved or was preserved. Ninety-one percent (69 of 76) considered the operation successful. CONCLUSIONS: Considering the seriousness of the conditions, quality-of-life scores after thoracic aortic surgery were acceptable, although lower than in a normal population, except for bodily pain. Postoperative quality of life justifies thoracic aortic surgical repair.