Objectives: Health-related quality of life (HRQoL) before elective cardiac surgery has rarely
been investigated. We aimed to estimate the preoperative HRQoL and the gait speed,
to identify patients with clinically relevant decreases which may have an impact on
the postoperative course.
Methods: 148 patients (69.5 ± 9.5 years) scheduled for elective cardiac surgery were enrolled.
Based on the HRQoL SF-12 questionnaire, the preoperative physical-health composite
score (PCS) and the preoperative mental-health composite score (MCS) were recorded.
Also, the preoperative gait speed and several other preoperative variables were evaluated.
The outcome parameters were orientated on MACCE and Non-MACCE criteria and the STS
outcomes. For the combined categorical outcome postoperative morbidity failure of
the cardiac-, pulmonary-, renal- and cerebral-system, as well as deep wound healing
disorders were counted for each patient. Patients without or with only one of the
outcomes were assigned zero points whereas more than one outcome failure was assigned
one point. Univariable and multivariable logistic regression analyses were performed
to evaluate the predictive value of PCS, MCS, gait speed and other variables regarding
postoperative morbidity.
Results: Preoperative PCS was 40.3 ± 10.2 and preoperative MCS 47.7 ± 8.9 in our patients.
The preoperative PCS correlated well with the gait speed of our patients (r = 0.34,
p < 0.001). Furthermore, univariable regression analysis identified STS morbidity or
mortality (OR = 1.07; 95%CI: 1.005–1.15; p = 0.03), gait speed (OR = 0.16; 95%CI: 0.04–0.74; p = 0.02) and PCS (OR = 0.93; 95%CI: 0.88–0.98; p = 0.005) as predictors of postoperative morbidity. Finally, postoperative morbidity
was independently associated with preoperative PCS (OR 0.94; 95%CI: 0.89–0.99; p = 0.03). A preoperative PCS value ≤ 44 (AUROC ± SE, 0.71 ± 0.05; 95%CI: 0.63–0.78;
p = 0.0001) predicted postoperative morbidity in these patients.
Conclusion: This study demonstrated for the first time that preoperative physical-health composite
score as part of the health-related quality of life assessment is predictive for the
postoperative course of cardiac surgery patients.
