Effect of Cardiac Surgery on One-Year Patient-Reported Outcomes: A Prospective Cohort Study

• Published in: The Annals of thoracic surgery Vol. 112; no. 5; pp. 1410 - 1416
• Main Authors: Charles, Eric J., Mehaffey, J. Hunter, Hawkins, Robert B., Green, China J., Craddock, Ashley, Tyerman, Zachary M., Larson, Nathaniel D., Kron, Irving L., Ailawadi, Gorav, Kozower, Benjamin D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01-11-2021
• Subjects: Aged; Cardiac Surgical Procedures; Cohort Studies; Female; Humans; Male; Middle Aged; Patient Reported Outcome Measures; Prospective Studies; Time Factors
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2020.09.061

Current cardiac surgery risk algorithms and quality measures focus on perioperative outcomes. However, delivering high-value, patient-centered cardiac care will require a better understanding of long-term patient-reported quality of life after surgery. Our objective was to prospectively assess the effect of cardiac surgery on long-term patient-reported outcomes.
Patients undergoing cardiac surgery at an academic medical center (2016 to 2017) were eligible for enrollment. Patient-reported outcomes were measured using the National Institutes of Health Patient-Reported Outcomes Measurement Information System preoperatively and 1 year postoperatively across five domains: mental health, physical health, physical functioning, social satisfaction, and applied cognition. Baseline data and perioperative outcomes were obtained from The Society of Thoracic Surgeons Database. The effect of cardiac surgery on long-term patient-reported quality of life was assessed.
Ninety-eight patients were enrolled and underwent cardiac surgery, with 92.9% (91 of 98) successful follow-up. The most common operation was coronary artery bypass graft surgery at 63.3% (62 of 98), with 60.2% (59 of 98) undergoing an elective operation. One-year all-cause mortality was 5.1% (5 of 98). Rate of major morbidity was 11.2% (11 of 98). Cardiac surgery significantly improved patient-reported outcomes at 1 year across four domains: mental health (preoperative 47.3 ± 7.7 vs postoperative 51.1 ± 8.9, P < .001), physical health (41.2 ± 8.2 vs 46.3 ± 9.3, P < .001), physical functioning (39.8 ± 8.6 vs 44.8 ± 8.5, P < .001), and social satisfaction (46.8 ± 10.9 vs 50.7 ± 10.8, P = .023). Hospital discharge to a facility did not affect 1-year patient-reported outcomes.
Cardiac surgery improves long-term patient-reported quality of life. Mental, physical, and social well-being scores were significantly higher 1 year postoperatively. Data collection with the National Institutes of Health Patient-Reported Outcomes Measurement Information System provides meaningful, quantifiable results that may improve delivery of patient-centered care.