Prospective assessment of quality of life of octogenarians after cardiac surgery: factors predicting long-term outcome

• Published in: Interactive cardiovascular and thoracic surgery Vol. 7; no. 5; pp. 813 - 818
• Main Authors: Jokinen, Janne J, Hippelainen, Mikko J, Hanninen, Tuomo, Turpeinen, Anu K, Hartikainen, Juha E.K
• Format: Journal Article
• Language: English
• Published: England Eur Assoc Cardio Surg 01-10-2008; European Association for Cardio-Thoracic Surgery
• Subjects: Age Factors; Aged; Aged, 80 and over; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Case-Control Studies; Humans; Kaplan-Meier Estimate; Odds Ratio; Proportional Hazards Models; Prospective Studies; Quality of Life; Risk Assessment; Risk Factors; Surveys and Questionnaires; Time Factors; Treatment Outcome; Octogenarians; Cardiac surgery; Survival; Quality of life
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2008.178095

a Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland
b Department of Surgery, Kuopio University Hospital, Kuopio, Finland
c Department of Neurology, Kuopio University Hospital, Kuopio, Finland
d Department of Medicine, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland
*Corresponding author. Tel.: [phone]; fax: [phone]. E-mail address : juha.hartikainen{at}kuh.fi (J.E.K. Hartikainen).
Our objective was to assess the long-term prognosis and quality of life (QoL) of elderly patients after cardiac surgery. The Nottingham Health Profile (NHP) QoL data were recorded from 104 patients who were older than 70 years at the time of primary cardiac surgery in 1993. All living patients were controlled at 15±3.2 months and 8.2±0.27 years after discharge. The 1-year, 5-year and actual survival rates were 94%, 76%, and 59%, respectively. Risk factors for death were urgency of the operation (relative risk ratio, 2.0; 95% confidence interval, 1.2–3.6), ejection fraction below 50% (2.1; 1.1–3.9), and preoperative renal failure (2.1; 1.0–4.0). Cardiac operated octogenarians took advantage from age and sex matched reference populations at 15 months in the NHP dimension of pain ( P =0.001). The QoL decreased gradually during the follow-up similarly in both groups in dimensions describing energy ( P =0.001), pain ( P =0.003), and mobility ( P =0.042). Diabetes, low energy score and high pain score at 15 months, treatment in intensive care unit >3 days, and duration of symptoms >120 days preoperatively were associated with impaired QoL. Survival and QoL were similar for cardiac operated octogenarians and age and sex matched controls at 15 months and 8.2 years after cardiac surgery.
Key Words: Quality of life; Survival; Octogenarians; Cardiac surgery
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eComment: Prospective assessment of quality of life of octogenarians after cardiac surgery
Leo A. Bockeria, I.I. Skopin, and E.V. Kuts
Interactive CardioVascular and Thoracic Surgery 2008 7: 818.
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