Nicholas Curcio1, Monica M Bennett2, Katherine R Hebeler2, Ann Marie Warren3, James R Edgerton4. 1. Division of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Baylor Scott and White Health, Dallas, Texas. 2. Baylor Scott and White Research Institute, Baylor Scott & White Health, Dallas, Texas. 3. Division of Trauma, Critical Care and Acute Care Surgery, Baylor University Medical Center, Baylor Scott and White Health, Dallas, Texas. Electronic address: annmarie.warren@bswhealth.org. 4. Baylor Scott and White Research Institute, Baylor Scott & White Health, Dallas, Texas; Division of Cardiothoracic Surgery, Washington University, Barnes Jewish Hospital, St Louis, Missouri; Department of Biology, College of Charleston, Charleston, South Carolina.
Abstract
BACKGROUND: Quality of life (QoL) is increasingly important in the era of patient-centered outcomes and value-based reimbursement. However most follow-up is limited to 30 days, and long-term data on QoL improvement associated with symptom relief are lacking. Therefore we sought to analyze QoL after cardiac surgery in a nonemergent, all-comers population. METHODS: Four hundred two patients undergoing routine cardiac surgery at 2 large urban hospitals in the Dallas, Texas area were enrolled. Follow-up was complete for 364 patients. Data were collected from August 2013 to January 2017. The Kansas City Cardiomyopathy Questionnaire was administered at baseline, 1 month, and 1 year after surgery. Repeated-measures analysis was used for each domain of the questionnaire for all procedures and stratified by procedure. If time was found to be a significant factor, pairwise analysis was performed with P values adjusted using the Tukey-Kramer method. RESULTS: There was a significant increase across all domains of Kansas City Cardiomyopathy Questionnaire scores for all procedures and for most domains when stratifying by procedure. This increase in QoL was most marked after 1 month. All domain scores increased through 1 year except symptom stability, which peaked at 1 month postsurgery and then regressed at 1 year, suggesting an overall improvement and stabilization of symptoms. The occurrence of complications did not alter this trajectory. CONCLUSIONS: QoL and other patient-centered outcomes are improved at 1 month and continue to improve throughout the year. Knowledge of these data is important for patient selection, fully informed consent, and shared decision-making.
BACKGROUND: Quality of life (QoL) is increasingly important in the era of patient-centered outcomes and value-based reimbursement. However most follow-up is limited to 30 days, and long-term data on QoL improvement associated with symptom relief are lacking. Therefore we sought to analyze QoL after cardiac surgery in a nonemergent, all-comers population. METHODS: Four hundred two patients undergoing routine cardiac surgery at 2 large urban hospitals in the Dallas, Texas area were enrolled. Follow-up was complete for 364 patients. Data were collected from August 2013 to January 2017. The Kansas City Cardiomyopathy Questionnaire was administered at baseline, 1 month, and 1 year after surgery. Repeated-measures analysis was used for each domain of the questionnaire for all procedures and stratified by procedure. If time was found to be a significant factor, pairwise analysis was performed with P values adjusted using the Tukey-Kramer method. RESULTS: There was a significant increase across all domains of Kansas City Cardiomyopathy Questionnaire scores for all procedures and for most domains when stratifying by procedure. This increase in QoL was most marked after 1 month. All domain scores increased through 1 year except symptom stability, which peaked at 1 month postsurgery and then regressed at 1 year, suggesting an overall improvement and stabilization of symptoms. The occurrence of complications did not alter this trajectory. CONCLUSIONS: QoL and other patient-centered outcomes are improved at 1 month and continue to improve throughout the year. Knowledge of these data is important for patient selection, fully informed consent, and shared decision-making.
Authors: Nicholas Curcio; Emma D Turner; Kiara Leonard; Monica M Bennett; Ann Marie Warren; James R Edgerton Journal: Proc (Bayl Univ Med Cent) Date: 2022-03-17