Abstract P331: The Impact of In-Hospital Postoperative Complications on Health Related Quality of Life in Cardiac Surgery Patients

Abstract

Background: Reports of successful cardiac surgical outcomes have focused on mortality and morbidity. However, health related quality of life (HRQL) is now being recognized as an important outcome measure. The objective of this study was to assess the impact of in-hospital postoperative complications on physical and mental HRQL in cardiac surgery patients from baseline to 6 and 12 months after surgery. Methods: Patients who underwent cardiac surgery since September 2005 were included (n=702). All patients completed the Short Form Health Survey (SF-12) prior to surgery, and at 6 and 12 months after surgery. Norm-based physical and mental components of HRQL were calculated, with higher scores indicating better HRQL. In-hospital postoperative complications were defined using the Society of Thoracic Surgeons guidelines. Results: Group 1 (n=533) had no in-hospital postoperative complications and Group 2 (n=169) experienced complications. The groups did not differ at baseline on physical or mental HRQL. There were significant main effects of time (F=32.9, p<0.001) and group (F=14.9, p<0.001) for physical HRQL, which showed an increase in scores over time and higher scores in Group 1. The significant interaction of time by group (F=6.6, p<0.02) indicated that physical HRQL increased more in Group 1 from baseline to 6 months and more in Group 2 from 6 to 12 months. The main effect of time was significant for mental HRQL (F=4.7, p<0.04), which showed an increase from baseline to 6 months and a slight decrease between 6 and 12 months. The interaction of time by group was not significant for mental HRQL. It is interesting to note, however, that the groups increased similarly from baseline to 6 months, but Group 1 showed a decline from 6 to 12 months and Group 2 continued to show an increase in mental HRQL from 6 to 12 months. Conclusion: In-hospital postoperative complications significantly affect improvements in HRQL. Patients that did not experience postoperative complications had a significantly better and faster improvement in physical HRQL from baseline to 1 year. Despite these differences in physical HRQL, the two groups increased similarly on mental HRQL. Further study is needed to explore this finding with a larger sample and longer follow-up time points after surgery.