Britt Borregaard1,2,3,4, Susanne S Pedersen5,6, Selina Kikkenborg Berg7,8,9, Jordi Dahl10,5, Ola Ekholm9, Kirstine Sibilitz7, Ann Dorthe Olsen Zwisler5,11, Sandra B Lauck12,13, Derek Kyte14, Melanie Calvert14, Lars Peter Schødt Riber15,10, Jacob Eifer Møller10,5,7. 1. Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark. britt.borregaard@rsyd.dk. 2. Faculty of Health Science, University of Southern Denmark, Odense, Denmark. britt.borregaard@rsyd.dk. 3. OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark. britt.borregaard@rsyd.dk. 4. Department of Cardiology, Odense University Hospital, Odense, Denmark. britt.borregaard@rsyd.dk. 5. Department of Cardiology, Odense University Hospital, Odense, Denmark. 6. Department of Psychology, University of Southern Denmark, Odense, Denmark. 7. The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 8. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 9. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 10. Faculty of Health Science, University of Southern Denmark, Odense, Denmark. 11. Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Nyborg, Denmark. 12. Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, Canada. 13. University of British Columbia, Vancouver, Canada. 14. Centre for Patient-Reported Outcomes Research (CPROR), Institute of Applied Health Research and NIHR, Birmingham Biomedical Research Centre, University of Birmingham, Edgbaston, Birmingham, UK. 15. Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark.
Abstract
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.
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.
Entities:
Keywords:
Cardiac surgery; Heart valves; Quality of life
Authors: Britt Borregaard; Jordi S Dahl; Sandra B Lauck; Jesper Ryg; Selina K Berg; Ola Ekholm; Jeroen M Hendriks; Lars P S Riber; Tone M Norekvål; Jacob E Møller Journal: Int J Cardiol Heart Vasc Date: 2020-11-13
Authors: Britt Borregaard; Jordi S Dahl; Ola Ekholm; Emil Fosbøl; Lars P S Riber; Kirstine L Sibilitz; Sasja M Pedersen; Thomas P H Rothberg; Maiken H Nielsen; Selina K Berg; Jacob E Møller Journal: PLoS One Date: 2020-10-07 Impact factor: 3.240
Authors: Sandra B Lauck; Suzanne J Baron; William Irish; Britt Borregaard; Kimberly A Moore; Candace L Gunnarsson; Seth Clancy; David A Wood; Vinod H Thourani; John G Webb; Harindra C Wijeysundera Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501