The impact of surgical aortic valve replacement on quality of life—a multicenter study

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 161; no. 4; pp. 1204 - 1210.e7
• Main Authors: Blokzijl, Fredrike, Houterman, Saskia, van Straten, Bart H.M., Daeter, Edgar, Brandon Bravo Bruinsma, George J., Dieperink, Willem, Reneman, Michiel F., Keus, Frederik, van der Horst, Iwan C.C., Mariani, Massimo A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2021
• Subjects: Aged; Aged, 80 and over; Aortic Valve - surgery; Aortic Valve Disease - epidemiology; Aortic Valve Disease - mortality; Aortic Valve Disease - psychology; Aortic Valve Disease - surgery; Elective Surgical Procedures - mortality; Elective Surgical Procedures - psychology; Elective Surgical Procedures - statistics & numerical data; Female; Heart Valve Prosthesis Implantation - mortality; Heart Valve Prosthesis Implantation - psychology; Heart Valve Prosthesis Implantation - statistics & numerical data; Humans; Male; Mental Health; Middle Aged; Patient Reported Outcome Measures; patient-reported outcomes; Quality of Life; surgical aortic valve replacement; patient-reported outcomes; PCS; AS; MCID; surgical aortic valve replacement; quality of life; MCS; SAVR; TAVR; QoL
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2019.09.184

To explore the effect of surgical aortic valve replacement on quality of life and the variance with age, particularly in patients at risk of deterioration. In an observational, multicenter, cohort study of routinely collected health data, patients undergoing and electively operated between January 2011 and January 2015 with pre- and postoperative quality of life data were included. Patients were classified into 3 age groups: <65, 65-79, and ≥80 years. Quality of life was measured at baseline and at 1-year follow-up using the Short-Form Health Survey-12 or SF-36. We defined a >5-point difference as a minimal clinically important difference. Multivariable linear regression analysis, with adjustment for confounders, was used to evaluate the association between age and quality of life. In 899 patients, mean physical health increased from 55 to 66 and mental health from 60 to 66. A minimal clinically important decreased physical health was observed in 12% of patients aged <65 years, 16% of patients aged 65-79 years, and 22% of patients aged ≥80 years (P = .023). A decreased mental health was observed in 15% of patients aged <65 years, 22% of patients aged 65-79 years, and 24% aged ≥80 years (P = .030). Older age and a greater physical and mental score at baseline were associated with a decreased physical and mental quality of life (P < .001). Patients surviving surgical aortic valve replacement on average improve in physical and mental quality of life; nonetheless, with increasing age patients are at higher risk of experiencing a deterioration. [Display omitted]