Abstract 16006: Impact of Psychosocial Factors on Survival After Cardiac Surgery
Introduction: Health-related quality of life (HRQL) has become a frequently used outcome to assess functionality in various clinical and health policy settings. However, there are no guidelines as to the appropriate length of time to follow-up cardiac surgery patients to examine HRQL and other psychosocial measures. The purpose of this study was to determine the impact of psychosocial factors on survival during long-term follow-up after cardiac surgery.
Hypothesis: It was hypothesized that poorer HRQL and other psychosocial factors would negatively impact survival during long-term follow-up after cardiac surgery.
Methods: After cardiac surgery (CABG, valve, and/or maze), a survey packet was sent to 1,702 patients who completed an HRQL questionnaire before surgery. Data were available for 713 patients who returned the packet. Psychosocial measures included CES-D for depression, ISEL for social support, and SF-36 for HRQL. Using multivariate Cox proportional hazards regression, we examined two models. Model 1 examined the absolute level of physical HRQL and Model 2 examined the change in physical HRQL from pre-surgery to survey.
Results: The mean age of the respondents was 65.0 ± 10.7 years; 24% were female. A mean of 31 months had elapsed since surgery at the time of the survey. In addition to months since surgery (HR = 0.94; P < 0.001) and EuroSCORE (HR = 1.18, P = 0.02) being significantly associated with survival, Model 1 found that a higher physical HRQL score at the time of survey was associated with better survival (HR = 0.93; P < 0.001). Although Model 2 found that change in physical HRQL score from pre-surgery to survey was not significantly related to survival (HR = 0.98, P = 0.17), higher depression score at survey was found to be associated with worse survival (HR = 1.06, P = 0.004).
Conclusions: These results indicate that symptoms of depression and poor HRQL negatively impact survival, even when assessed during long-term follow-up after cardiac surgery. Our findings suggest that psychosocial factors should continue to be monitored in cardiac surgery patients throughout the course of their recovery and as they are followed over time for their heart conditions.
Author Disclosures: L.M. Martin: None. S.D. Holmes: None. L.E. Stone: None. D.J. Shuman: None. N. Ad: Speakers Bureau; Modest; Medtronic, Inc., AtriCure, Inc.. Consultant/Advisory Board; Modest; Medtronic, Inc., AtriCure, Inc..
- © 2014 by American Heart Association, Inc.