Evaluation of quality of life after cardiac surgery in high-risk patients

Abstract

Background: Conventionally, there is controversy over subjecting high-risk patients to cardiac operations, due to major postoperative complications. Higher survival rates and less morbidity as well as better quality of life can be good predictors of the outcome of surgery. This study evaluates the quality of life before and 12 months after cardiac operations on high-risk patients. Methods: In this study, the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was used to separate high-risk patients from others. The quality of life was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) before surgery and one year afterward. Based on SF-36, the score for each of the eight different dimensions of the quality of life was quantified; and, their differences between pre-surgery and post-follow up period were analyzed. Results: 126 high-risk patients were included in this study. The mean age of the patients was 64.29 ± 12.35 years. The median of EuroSCORE II score in these cases was 6.83 (6.04-25.98). The results reveal that the majority of the quality of life dimensions, except mental health, improved significantly after the follow-up period. Conclusion: Cardiac surgery on high-risk patients can noticeably promote the different aspects of their quality of life; although, such improvements should be considered against surgical complications. long-term mortality and morbidity following cardiac surgery have been well assessed. Studies have reported higher mortality rates among high-risk patients as well as more complications after surgery [Nashef 1999; Riera 2011]. So, the question still remains as to whether or not to perform an operation on high-risk patients. Recent surveys have accorded greater emphasis on QOL as a significant indicator of a patient's health post cardiac surgery. Nevertheless, most of such studies examined only preoperative risk models or QOL individually [Colak 2008; Peric 2005; Rumsfeld 2001]; therefore, there is a need to quantify QOL of both pre- and post-surgery in each specific risk group. This study aims to evaluate changes in QOL at 12-month follow-up of high-risk patients after cardiac surgery, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II.