What to expect after open heart valve surgery? Changes in health-related quality of life

Britt Borregaard, Susanne S Pedersen, Selina Kikkenborg Berg, Jordi Dahl, Ola Ekholm, Kirstine Sibilitz, Ann Dorthe Olsen Zwisler, Sandra B. Lauck, Derek Kyte, Melanie Calvert, Lars Peter Schødt Riber, Jacob Eifer Møller

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Purpose: To (i) describe changes in health-related quality of life (HRQoL) pre-operatively, at discharge, and 4 weeks after discharge following open heart surgery, (ii) compare the performance of the EuroQol Questionnaire (EQ-5D 5L) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) against an anchor-based approach, and to (iii) investigate the association between HRQoL and 180-day readmission.

Methods: A prospective, consecutive cohort (single-center study) of 291 patients completed the EQ-5D 5L and KCCQ pre-operatively, at discharge and 4 weeks post-discharge. Changes in HRQoL over time were evaluated, and the performance of the instruments was investigated. The association between HRQoL and readmission were investigated with Cox Proportional Hazard models.

Results: Scores of the EQ-5D Index and VAS decreased significantly from the pre-operative assessment to discharge and improved from discharge to 4 weeks after. The KCCQ scores significantly improved from baseline to 4 weeks after. Minimal clinically important improvements from before surgery to 4 weeks after were seen among 24% (EQ-5D Index), 45% (EQ-5D VAS), and 57% (KCCQ). More than one-third experienced worse HRQoL 1 month after discharge. Area under the curve (AUC) (performance of the instruments) demonstrated the following: EQ-5D Index AUC 0.622 (95% CI 0.540–0.704), VAS AUC 0.674 (95% CI 0.598–0.750), and KCCQ AUC 0.722 (95% CI 0.65–0.792). None of the HRQoL measurements were associated with 180-day readmission.

Conclusions: This study revealed that HRQoL measured with the EQ-5D is significantly worse at discharge compared to before surgery, but scores increases within the first month measured with the EQ-5D and the KCCQ. The EQ-5D and KCCQ have a moderate correlation with an anchor-based approach but were not associated with readmission.
Original languageEnglish
Number of pages12
JournalQuality of Life Research
Early online date24 Dec 2019
Publication statusE-pub ahead of print - 24 Dec 2019


  • Quality of life
  • Heart valves
  • Cardiac surgery


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