Abstract P332: Younger Patients Report Impaired Mental Functioning in Health-Related Quality of Life After Valve Surgery

Abstract

Background: Heart valve surgery is indicated for a number of presenting conditions and is performed even in young patients. It is known that younger age can be protective for surgical outcomes, such as mortality, but less is know about how age impacts quality of life in patients undergoing valve surgery. Objective: To determine if age was associated with health related quality of life (HRQL) after valve surgery. Methods: Patients who underwent valve surgery (stand alone or concomitant) since late 2005 were included in these analyses (N=288). The age range for this sample was 21-87. Patients were divided into tertiles based on age: younger (age < 60 years; n=95), older (age ≥ 60 and < 72; n=93) and oldest (age ≥ 72; n=100). HRQL was measured using the Medical Outcomes Trust Short Form 12 (SF-12) prior to surgery, and at 6 and 12 months post-surgery. The SF-12 mental component summary (MCS) and physical component summary (PCS) scores were calculated to assess differences in HRQL over time based on age groups. Results: There was a significant main effect of time for MCS (F=5.6, p<0.006) and PCS (F=39.6, p<0.001) with significant increases in HRQL from baseline through 12 months. No significant interaction of time by age group was found for MCS or PCS. All three groups increased similarly for both MCS and PCS. There was a significant main effect of group for both MCS (F=4.1, p<0.02) and PCS (F=22.3, p<0.001). The younger group had significantly lower MCS scores as compared to the older group (p<0.02), regardless of time point. However, the younger group had significantly higher PCS scores as compared to the older (p<0.04) and oldest groups (p<0.001). The older group also had significantly higher PCS scores than the oldest group (p<0.001). Conclusion: Improvement in HRQL was shown across all age groups in both MCS and PCS. Despite the fact that the younger patients had the highest physical HRQL, this group had the lowest mental HRQL regardless of time point. These results suggest that valve disease in the younger patients had a detrimental effect on their mental HRQL prior to and after surgery. Further study is needed to investigate the impact of valve disease and surgery on quality of life in younger patients, particularly on how to improve the psychological experience.