Improved health-related quality of life in patients 6 and 12 months after surgical aortic valve replacement

Figures & data

Table 1. Participants and non-participants.

	Participants in the study		Non-participants
	Female	Male	Total (86 female, 176 male)
Number of patients	213	412	262
Age (mean with SD)	71.74 (SD 9.65)	67.25 (SD 10.9)	67.3 (SD 12.05)
Type of surgery n (%)
Surgical aortic valve replacement (SAVR)	189 (88.7%)	354 (85.9%)	229 (87.4%)
SAVR and mitral valve surgery	24 (11.3%)	58 (14.1%)	22 (12.6%)
SAVR and tricuspid valve surgery	29 (13.6%)	54 (13.1%)	31 (11.8%)
SAVR with CABG	38 (17.8%)	117 (28.4%)	73 (27.9%)
Timing of operation
Elective	206 (96.7%)	393 (95.4%)	249 (95.0%)
Urgent	7 (3.3%)	14 (3.4%)	10 (3.8%)
Emergency	0 (0.0%)	5 (1.2%)	3 (1.1%)
Body mass index, kg/m^2 (mean with SD)	27.9 (SD 4.98)	28.6 (SD 16.8)	28.24 (SD 4.78)
Left ventricular ejection fraction in % (mean with SD)	61.58 (10.74)	56.56 (SD 10.9)	57.84 (SD 11.35)
Body surface area in m^2 (mean with SD)	1.80 (0.18)	2.06 (0.19)	1.98 (SD 0.23)
EuroScore II risk score in % (mean with SD)	2.84 (SD 2.46)	2.17 (SD 2.28)	2.56 (SD 2.74)
Smoking (n, %)
Yes	8 (3.8%)	35 (8.5%)	18 (6.9%)
None	153 (71.8%)	214 (51.9%)	145 (55.3%)
ex-smoker	16 (7.5%)	83 (20.1%)	56 (21.4%)
n.a.	36 (16.9%)	80 (19.4%)	43 (16.4%)
Family history of CAD (n, %)
Yes	42 (19.7%)	82 (19.9%)	57 (21.8%)
None	95 (44.6%)	180 (43.7%)	123 (46.9%)
n.a.	76 (35.7%)	150 (36.4%)	82 (31.3%)
Hypertension (n, %)
Yes	129 (60.6%)	224 (54.4%)	155 (59.2%)
None	49 (23.0%)	126 (30.6%)	67 (25.6%)
n.a.	35 (16.4%)	62 (15.0%)	40 (15.3%)
Hyperlipidemia (n, %)
Yes	95 (44.6%)	184 (44.7%)	116 (44.3%)
None	72 (33.8%)	148 (35.9%)	100 (38.4%)
n.a.	46 (21.6%)	80 (19.4%)	46 (17.8%)
Diabetes (n, %)
Yes	32 (15.0%)	72 (17.5%)	48 (18.3%)
None	146 (68.5%)	276 (67.0%)	172 (65.6%)
n.a.	35 (16.4%)	64 (15.5%)	42 (16.0%)

CABG: coronary artery bypass grafting; n.a.: not available; n: number of patients.

Figure 1. EQ VAS score before and after surgery. Median with interquartile range of EQ VAS scores of the patients’ self-rated health at preoperative, 6- and 12-month evaluations. The improvement of EQ VAS score is better at 6 and 12 months as compared to preoperative score in related-samples Wilcoxon signed rank test.

Table 2. Change in the number of patients reporting problems.

	Total	No problems	Moderate problems	Extreme problems	Reporting any problems	Change in reporting problems	p
Mobility
Preoperative	624	269 (43.1%)	355 (56.9%)	0 (0%)	355 (56.9%)
6 months postoperative	524	325 (62.0%)	197 (37.6%)	2 (0.4%)	199 (38.0%)	–18.90%	<.01
12 months postoperative	366	246 (67.2%)	120 (32.8%)	0 (0%)	120 (32.8%)	–24.10%	<.01
Self-care
Preoperative	624	351 (56.3%)	247 (39.6%)	26 (4.2%)	273 (43.8%)
6 months postoperative	524	393 (75.0%)	123 (23.5%)	8 (1.5%)	131 (25.0%)	–18.80%	<.01
12 months postoperative	366	326 (89.1%)	39 (10.7%)	1 (0.3%)	40 (10.9%)	–32.90%	<.01
Usual activities
Preoperative	623	564 (90.5%)	57 (9.1%)	2 (0.3%)	59 (9.4%)
6 months postoperative	523	480 (91.8%)	40 (7.6%)	3 (0.6%)	43 (8.2%)	–1.20%	.573
12 months postoperative	366	348 (95.1%)	17 (4.6%)	1 (0.3%)	18 (4.9%)	–4.50%	<.001
Pain/discomfort
Preoperative	620	252 (40.6%)	358 (57.7%)	10 (1.6%)	368 (59.4%)
6 months postoperative	524	334 (63.7%)	185 (35.3%)	5 (1.0%)	190 (36.3%)	–23.10%	<.01
12 months postoperative	123	242 (66.3%)	119 (32.6%)	4 (1.1%)	123 (33.7%)	–25.70%	<.01
Anxiety/depression
Preoperative	616	528 (85.7%)	85 (13.8%)	3 (0.5%)	88 (14.3%)
6 months postoperative	524	470 (89.7%)	52 (9.9%)	2 (0.4%)	54 (10.3%)	–4.00%	<.01
12 months postoperative	367	347 (94.6%)	20 (5.4%)	0 (0.0%)	20 (5.4%)	–8.90%	<.01

Number of patients (with %) by their reporting of symptom status in five dimensions of EQ-5D-3L. Reporting any problems indicates a sum of cases in moderate and extreme problems categories. Comparisons and statistical testing have been performed in comparison to numbers of cases in preoperative quantities.

Table 3. Results of multivariable logistic regression analysis.

Covariate	β	Wald	p	OR	CI 95%
Improved self-care	0.854	3.906	.048	2.349	1.007–5.477
Improved pain or discomfort	1.166	6.199	.013	3.21	1.282–8.039
Improved usual activities	1.14	1.175	.278	3.126	0.398–24.553
Improved mobility	0.023	0.003	.955	1.023	0.457–2.289
Improved anxiety or depression	0.392	0.371	.543	1.48	0.419–5.229

Multivariable logistic regression analysis of postoperative EQ VAS at 12 months as dependent variable and the dimensions of EQ-5D as explanatory (independent) variables.

Hosmer–Lemeshow test was used to determine the goodness of fit of the model with 6 d.f., p = .846.