BACKGROUND: Optimal selection of patients and choice of treatment methods in cardiac surgery calls for methods to predict outcome both in terms of mortality and health-related quality of life (HRQoL). Our target was to evaluate whether indicators predicting mortality can also be used to predict follow-up HRQoL. METHODS: Preoperative and intensive care-related data of 571 elective cardiac surgery patients treated in the Helsinki University Central Hospital were used to predict, in a stepwise (forward) binary logistic regression, the probability of being dead at six months after operation. Furthermore, Tobit regression models were employed to predict the follow-up HRQoL of patients using also treatment complications and patients' experiences of pain and restlessness during treatment as explanatory variables. RESULTS: The EuroSCORE, renal, respiratory and neurological complications as well as urgent sternotomy were all statistically significant predictors of mortality. By contrast, follow-up HRQoL was predicted by the baseline HRQoL, diabetes and male gender as well as experience of pain and restlessness during the ICU stay. CONCLUSION: Mortality and HRQoL after cardiac surgery appear to be explained by different factors. Pain and restlessness during ICU treatment affect follow-up HRQoL in a negative manner and as potentially modifiable factors, need attention during treatment.
BACKGROUND: Optimal selection of patients and choice of treatment methods in cardiac surgery calls for methods to predict outcome both in terms of mortality and health-related quality of life (HRQoL). Our target was to evaluate whether indicators predicting mortality can also be used to predict follow-up HRQoL. METHODS: Preoperative and intensive care-related data of 571 elective cardiac surgery patients treated in the Helsinki University Central Hospital were used to predict, in a stepwise (forward) binary logistic regression, the probability of being dead at six months after operation. Furthermore, Tobit regression models were employed to predict the follow-up HRQoL of patients using also treatment complications and patients' experiences of pain and restlessness during treatment as explanatory variables. RESULTS: The EuroSCORE, renal, respiratory and neurological complications as well as urgent sternotomy were all statistically significant predictors of mortality. By contrast, follow-up HRQoL was predicted by the baseline HRQoL, diabetes and male gender as well as experience of pain and restlessness during the ICU stay. CONCLUSION: Mortality and HRQoL after cardiac surgery appear to be explained by different factors. Pain and restlessness during ICU treatment affect follow-up HRQoL in a negative manner and as potentially modifiable factors, need attention during treatment.
Authors: Julie Sanders; Tracey Bowden; Nicholas Woolfe-Loftus; Mandeep Sekhon; Leanne M Aitken Journal: Health Qual Life Outcomes Date: 2022-05-18 Impact factor: 3.077
Authors: Christopher R King; Krisztina E Escallier; Yo-El S Ju; Nan Lin; Ben Julian Palanca; Sherry Lynn McKinnon; Michael Simon Avidan Journal: BMJ Open Date: 2019-08-26 Impact factor: 2.692