Patient-centered Outcomes After Totally Endoscopic Cardiac Surgery: One-year Follow Up
Jade Claessens1, Alaaddin Yilmaz2, Silke Van Genechten2, Marithé Claes1, Loren Packlé2, Maud Pierson1, Jeroen Vandenbrande2, Abdullah Kaya1, Björn Stessel1.
1Hasselt University, Hasselt, Belgium, 2Jessa Hospital, Hasselt, Belgium.
BACKGROUND:Over the years, patient-centered outcomes have gained popularity in surgical care research. Health-related quality of life (HRQL) is a measure in which the patient’s health status can be determined without professional interpretations. This allows for a better understanding of how the surgery affects the patient’s health. A study regarding patient-centered outcomes until 90 days after the surgery was published in May 2022. The HRQL decreased 14 days after surgery, then it returned to baseline levels at 30 days. After 90 days, the HRQL significantly improves. The aforementioned study only focuses on a short-term follow-up of the patients. Hence, this follow-up study aims to assess the HRQL one year after the surgery.
METHODS:Patients were enrolled in this prospective observational cohort study from November 2019 to October 2020. The surgery is performed through endoscopic ports (5mm) and a utility port (3 cm). The HRQL was assessed using the 36-item Short Form and 5-dimensional European QoL questionnaires (EQ-5D) at baseline, 14, 30, 90 days, and one year after the surgery. A physical and mental component score is calculated based on a reference population of patients with ischemic heart disease. Every value above or below 50 is above or below the reference population. RESULTS:A total of 201 patients were included in this trial, of which 99 patients underwent endoscopic coronary artery bypass grafting, 57 endoscopic aortic valve replacement, 16 endoscopic mitral valve repair/replacements, and 23 concomitant procedures. The physical component score significantly improved over the time period of one year (54.39 [43.91, 60.67] at baseline and 61.84 [55.55, 74.57] after one year (p<0.001)). Additionally, the mental component score significantly improved after one year but not within 90 days after the surgery (p<0.001). Moreover, the EQ-5D index value significantly improves from 0.81 [0.64, 1] at baseline to 0.91 [0.80,1] after one year (p<0.001). Lastly, the visual analog scale of the EQ-5D indicates that patients score their health significantly higher after one year (70 [60,80] % at baseline and 80 [70, 85] % after one year, p<0.001).
CONCLUSIONS: In conclusion, endoscopic cardiac surgery significantly improves the HRQL one year after the surgery.
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