Mental Well-being Following Thoracic Aortic Surgery: A Comparative Study of Acute and Elective Cases

Background: Traumatic experiences may significantly impact patients’ mental and physical well-being. This study aims to investigate changes in health-related quality of life (HRQoL) following acute and elective open surgical thoracic aortic repair.

Methods: In a prospective study, consecutive patients undergoing open aortic surgery between 2019 and 2023 were investigated using SF-36 HRQoL questionnaires. Data were collected at three time points: preoperatively (elective cases only), 30 days post-surgery, and 24 months post-surgery. A 2:1 propensity score matching was performed using a German reference population.

Results: Out of 1,065 patients, 701 were included in the study with 72% undergoing elective surgery. Analysis was performed on 1,291 questionnaires. The median age of participants was 61 years (range 19–90), and 71% were male. Elective patients who filled pre- and post-surgery questionnaires regained their pre-surgery mental and physical state after 24 months. However, compared with the reference population, a significant reduction in vitality (54.27 ± 19.01 versus 87.91 ± 19.72, p < 0.001), social function (80.58 ± 22.94 versus 85.46 ± 31.77, p < 0.001), and emotional well-being (70.07 ± 39.79 vs. 85.46 ± 31.77, p < 0.001) was still observed after 2 years. Comparing elective and acute cases at 24 months, the physical health summary scores expectedly tend toward lower values in acute patients (45.9 ± 9.2 versus 46.9 ± 8.8, p = 0.06) but without significance. Also, patients undergoing emergent surgery demonstrated significantly lower mental health summary scores (44.5 ± 13.9 versus 46.7 ± 12.4, p < 0.05). In relation to the reference population, both elective and acute patients showed significantly reduced summary scores of mental health (p < 0.0001), but no significant differences were observed with regards to physical health.

Conclusion: This study showed that, although patients undergoing thoracic aortic repair recover physically within 2 years, they still experience significant reductions in specific mental health domains compared with the reference population. Acute patients tend to have poorer recovery, particularly in mental well-being. These findings highlight the importance of long-term psychological support and follow-up for both acute and elective thoracic aortic repair patients, with potentially greater emphasis needed for acute cases.

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Artikel online veröffentlicht:
11. Februar 2025