Health-related quality of life of patients after surgery for acute Type A aortic dissection

Interact Cardiovasc Thorac Surg. 2018 Jul 1;27(1):48-53. doi: 10.1093/icvts/ivy036.

Abstract

Objectives: Acute Type A aortic dissection (ATAAD) and the ensuing surgical therapy may be experienced as a traumatic event by patients. This study aimed at analysing the prevalence of post-traumatic stress disorder (PTSD) and the physical and mental well-being of survivors of surgically treated ATAAD.

Methods: A total of 393 survivors were contacted and asked to fill in various health questionnaires.

Results: Two hundred and ten (53%) patients returned the questionnaires. The mean follow-up was 51 ± 27.8 months. The results showed that 67.6% had high blood pressure, 12.9% had pre-existing diseases of the aorta and 31.5% or 27% of these groups were at risk for PTSD according to the health questionnaires. Duration of intensive care unit or hospital stay had no effect on the risk for PTSD. According to the questionnaire, Short Form 12, physical and mental well-being was significantly reduced in the patients compared to a large German norm sample, even after adjustment for differences in age between the 2 cohorts. Physical activity prior to the event was associated with improved physical and mental well-being but did not reduce the risk for PTSD.

Conclusions: Emergency surgery for ATAAD is associated with high risk for PTSD, which seems to negatively affect physical and mental well-being. More efforts should be directed at prevention and early diagnosis and therapy of PTSD. This study has evaluated 8-year trends in the presentation, diagnosis and outcomes such as physical and mental measures and prevalence rates of PTSD in patients who have undergone an emergency operation for ATAAD.

MeSH terms

  • Adult
  • Aged
  • Aortic Aneurysm / psychology
  • Aortic Aneurysm / surgery*
  • Aortic Dissection / psychology
  • Aortic Dissection / surgery*
  • Female
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Mental Health
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Prevalence
  • Quality of Life*
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Surveys and Questionnaires
  • Survivors / psychology*