Factors affecting the quality of life before and after surgery in patients with chronic thromboembolic pulmonary hypertension.

Abstract

To test the hypothesis that quality of life (QoL) parameters before surgery in patients with chronic thromboembolic pulmonary hypertension (CTEPH) are influenced by clinical determinants related to the underlying disease and to examine QoL parameters affected in the long-term after the operation by complications presenting in the early postoperative period. This prospective cohort study included 128 patients who presented with CTEPH before and after pulmonary thromboendarterectomy (PTE; 1-year follow-up). All patients were examined regarding QoL using the Short-Form 36 Health Survey Questionnaire (SF-36). In patients with CTEPH, PTE provided immediate improvement in terms of pulmonary hemodynamic parameters and favorable effects on long-term outcome, including QoL 1 year after surgery. Multivariate analysis showed that systolic pulmonary arterial pressure, right ventricular ejection fraction, and the presence of coronary artery disease and chronic obstructive pulmonary disease (COPD) were independent factors affecting QoL on several SF-36 subscales in patients with CTEPH prior to surgery. The factors that affect patient QoL 1 year after surgery on some SF-36 subscales included the presence of coronary artery disease, COPD, heart failure, residual pulmonary hypertension, and prolonged ventilation, neurological complications in the early postoperative period of PTE. Surgical treatment for CTEPH leads to an increase in QoL in all SF-36 subscales, excluding general health perceptions. Factors affecting QoL in patients with CTEPH included severity of pulmonary arterial hypertension, comorbidity, and complications in the early postoperative period after PTE, such as heart failure, neurologic problems, residual pulmonary hypertension, and prolonged ventilation.