Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes

J. Hunter Mehaffey, Robert B. Hawkins, Eric J. Charles, Irving L. Kron, Gorav Ailawadi, John A. Kern, Mark E. Roeser, Benjamin Kozower, Nicholas R. Teman

Research output: Contribution to journalArticle

Abstract

Background: Current reporting on cardiac surgical outcomes focuses on a patient's status at 30 days and lacks long-term meaningful data. The purpose of this study was to determine the impact of complications after cardiac operation on patient-reported outcomes (PROs) at 1 year after surgery. Methods: All patients undergoing cardiac operation at an academic institution (2014-2015) were contacted 1 year after surgery to obtain vital status, location, and PROs using the validated National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH-PROMIS). Records were merged with Society of Thoracic Surgeons (STS) data, and multivariate linear regression evaluated the risk-adjusted effects of complications on 1-year PROs. Results: A total of 782 eligible patients underwent cardiac operation, with PROs data available for 91% of patients alive at 1 year (648 of 716). Mean NIH-PROMIS scores were global physical health (GPH), 48.8 ± 10.2; global mental health (GMH), 51.3 ± 9.5; and physical functioning (PF), 45.5 ± 10.2 (reference score for general adult population, 50 ± 10). Occurrence of an STS Major Morbidity (prolonged ventilation, renal failure, reoperation, stroke, or deep sternal wound infection) significantly reduced 1-year PROs (GPH, 45.4 ± 8.9 [P <.001]; GMH, 48.6 ± 9.5 [P =.01]; PF, 40.9 ± 10.2 [P <.001]). After risk adjustment, incidence of a STS Major Morbidity, prolonged ventilation, or renal failure had a significant adverse effect on 1 or more PRO domains. Conclusions: Although cardiac surgical patients have PROs scores similar to the general population, complications after cardiac operation continue to negatively influence patient quality of life 1 year after surgery. Use of NIH-PROMIS shows that prolonged ventilation and renal failure have the largest impact on 1-year patient-reported outcomes.

Original languageEnglish (US)
Pages (from-to)43-48
Number of pages6
JournalAnnals of Thoracic Surgery
Volume109
Issue number1
DOIs
StatePublished - Jan 2020
Externally publishedYes

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National Institutes of Health (U.S.)
Information Systems
Renal Insufficiency
Ventilation
Mental Health
Patient Reported Outcome Measures
Thorax
Morbidity
Risk Adjustment
Wound Infection
Reoperation
Population
Linear Models
Stroke
Quality of Life
Global Health
Incidence
Surgeons

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Mehaffey, J. H., Hawkins, R. B., Charles, E. J., Kron, I. L., Ailawadi, G., Kern, J. A., ... Teman, N. R. (2020). Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes. Annals of Thoracic Surgery, 109(1), 43-48. https://doi.org/10.1016/j.athoracsur.2019.05.067

Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes. / Mehaffey, J. Hunter; Hawkins, Robert B.; Charles, Eric J.; Kron, Irving L.; Ailawadi, Gorav; Kern, John A.; Roeser, Mark E.; Kozower, Benjamin; Teman, Nicholas R.

In: Annals of Thoracic Surgery, Vol. 109, No. 1, 01.2020, p. 43-48.

Research output: Contribution to journalArticle

Mehaffey, JH, Hawkins, RB, Charles, EJ, Kron, IL, Ailawadi, G, Kern, JA, Roeser, ME, Kozower, B & Teman, NR 2020, 'Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes', Annals of Thoracic Surgery, vol. 109, no. 1, pp. 43-48. https://doi.org/10.1016/j.athoracsur.2019.05.067
Mehaffey, J. Hunter ; Hawkins, Robert B. ; Charles, Eric J. ; Kron, Irving L. ; Ailawadi, Gorav ; Kern, John A. ; Roeser, Mark E. ; Kozower, Benjamin ; Teman, Nicholas R. / Impact of Complications After Cardiac Operation on One-Year Patient-Reported Outcomes. In: Annals of Thoracic Surgery. 2020 ; Vol. 109, No. 1. pp. 43-48.
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abstract = "Background: Current reporting on cardiac surgical outcomes focuses on a patient's status at 30 days and lacks long-term meaningful data. The purpose of this study was to determine the impact of complications after cardiac operation on patient-reported outcomes (PROs) at 1 year after surgery. Methods: All patients undergoing cardiac operation at an academic institution (2014-2015) were contacted 1 year after surgery to obtain vital status, location, and PROs using the validated National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH-PROMIS). Records were merged with Society of Thoracic Surgeons (STS) data, and multivariate linear regression evaluated the risk-adjusted effects of complications on 1-year PROs. Results: A total of 782 eligible patients underwent cardiac operation, with PROs data available for 91{\%} of patients alive at 1 year (648 of 716). Mean NIH-PROMIS scores were global physical health (GPH), 48.8 ± 10.2; global mental health (GMH), 51.3 ± 9.5; and physical functioning (PF), 45.5 ± 10.2 (reference score for general adult population, 50 ± 10). Occurrence of an STS Major Morbidity (prolonged ventilation, renal failure, reoperation, stroke, or deep sternal wound infection) significantly reduced 1-year PROs (GPH, 45.4 ± 8.9 [P <.001]; GMH, 48.6 ± 9.5 [P =.01]; PF, 40.9 ± 10.2 [P <.001]). After risk adjustment, incidence of a STS Major Morbidity, prolonged ventilation, or renal failure had a significant adverse effect on 1 or more PRO domains. Conclusions: Although cardiac surgical patients have PROs scores similar to the general population, complications after cardiac operation continue to negatively influence patient quality of life 1 year after surgery. Use of NIH-PROMIS shows that prolonged ventilation and renal failure have the largest impact on 1-year patient-reported outcomes.",
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AU - Hawkins, Robert B.

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AU - Kron, Irving L.

AU - Ailawadi, Gorav

AU - Kern, John A.

AU - Roeser, Mark E.

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