To explore the effect of surgical aortic valve replacement on quality of life and the variance with age, particularly in patients at risk of deterioration.
In an observational, multicenter, cohort study of routinely collected health data, patients undergoing and electively operated between January 2011 and January 2015 with pre- and postoperative quality of life data were included. Patients were classified into 3 age groups: <65, 65-79, and ≥80 years. Quality of life was measured at baseline and at 1-year follow-up using the Short-Form Health Survey-12 or SF-36. We defined a >5-point difference as a minimal clinically important difference. Multivariable linear regression analysis, with adjustment for confounders, was used to evaluate the association between age and quality of life.
In 899 patients, mean physical health increased from 55 to 66 and mental health from 60 to 66. A minimal clinically important decreased physical health was observed in 12% of patients aged <65 years, 16% of patients aged 65-79 years, and 22% of patients aged ≥80 years (P = .023). A decreased mental health was observed in 15% of patients aged <65 years, 22% of patients aged 65-79 years, and 24% aged ≥80 years (P = .030). Older age and a greater physical and mental score at baseline were associated with a decreased physical and mental quality of life (P < .001).
Patients surviving surgical aortic valve replacement on average improve in physical and mental quality of life; nonetheless, with increasing age patients are at higher risk of experiencing a deterioration.
Abbreviations and Acronyms:AS (aortic valve stenosis), MCID (minimal clinically important difference), MCS (mental component summary score), PCS (physical component summary score), QoL (quality of life), SAVR (surgical aortic valve replacement), TAVR (transcatheter aortic valve replacement)
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Published online: October 30, 2019
Accepted: September 24, 2019
Received in revised form: September 11, 2019
Received: June 20, 2019
© 2019 by The American Association for Thoracic Surgery
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- Commentary: Quality of life following aortic valve replacement in era of transcatheter approach: Change of timeThe Journal of Thoracic and Cardiovascular SurgeryVol. 161Issue 4
- PreviewWith increasing life expectancy and the upward tick of aging in the populations of Western countries, aortic valve stenosis has become one of the most common structural heart valvular diseases, and the incidence of aortic valve stenosis is increasing. An estimated 4.2 to 5.6 million adults in the United States have some form of clinically important valve disease.1
- Commentary: Age is just an element of the quality of life puzzle following aortic valve replacementThe Journal of Thoracic and Cardiovascular SurgeryVol. 161Issue 4
- PreviewIn the current issue of the Journal, Blokzijl and colleagues1 reported the impact of surgical aortic valve replacement (SAVR) on physical and mental quality of life in 899 patients. The association between age and health-related quality of life (HRQL) was explored, and, as expected, older patients were identified the most at risk of experiencing deterioration. The authors’ analysis might be biased by the large number of nonrespondents (29% of patients), the merging of the Short Form-12 and Short Form-36 health status instrument values, and the relatively low-risk profile of these patients.