Long-term Assessment of Survival, Functional Status and Quality of Life of Patients Requiring Prolonged ICU Treatment after Cardiac Surgery

Background: Aortic stenosis (AS) in octogenarians is most common and debilitating second to coronary artery disease, leading to poor quality of life (QOL). AS has higher mortality comparison to isolated revascularization (CABG) surgery. Studies indicated the benefits of both types of surgeries in octogenarians in improvement of functionality and QOL. Objective of this study was to assess long-term survival, functional status, living arrangements and QOL in the octogenarians in aortic valve and CABG surgery. Methods: Between September 2000 and September 2006, 304 consecutive patients aged 80-92 years (mean: 83.2 ± 2.8) who had CABG (196) and AVR (108) with or without CABG were identified. All survivors were followed prospectively for a mean period of 36.5 months (7-78). Their QOL and functional status was assessed by using items from the Barthel index and Karnofsky performance score. In this study we used observable descriptive measures to describe QOL (i.e. Phenomenology: the study of lived experience), in a number of domain activities of day-today life in our elderly patients. Results: Overall 30-day in-hospital mortality (CABG/AVR; n::%) rate was (24/10::12.2/9.2%). The non-adjusted survival rate was 82.7/78.2% and 72.4/66.5% at 1 and 3 years respectively. Among the 207 (136/71::69.4/65.7%) survivors from a cohort of 304, (89/44::65.4/62.0%) were autonomous, (38/18::27.9/25.4%) were semiautonomous, and 9/9::6.6/12.6%) were dependents. Among the survivors (103/47::75.7/66.2%) living in own homes, (24/15::17.6/21.1%) in residences and (9/9::6.6/12.6%) in the supervised setting. The surviving patients were involved social (133/68::97.8/95.8%), cognitive (132/68::97/95.9%), physical (126/65::92.6/91.5%), and/or volunteer and creative activities (27/18::19.8/25.3%). All survivors were cardiac symptoms free. Conclusions: Early and long-term survival in CABG and AVR group was not significantly different. More than 90% of survivors were physically active. Functional status and QOL were not significantly different in two groups. This long-term information can help when considering risks and benefits of Cardiac surgery and planning the future need for health care resources among octogenarians.

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Functional status and quality of life (QoL) in long-term survivors of cardiac arrest after cardiac surgery

Critical Care ◽

10.1186/cc933 ◽

2000 ◽

Vol 4 (Suppl 1) ◽

pp. P214

Author(s):

A Anthi ◽

I Dimopoulou ◽

A Michalis ◽

GE Tzelepis

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Cardiac Surgery ◽

Functional Status ◽

Long Term Survivors

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Quality of life and predictors of long-term survival after cardiac surgery

European Journal of Anaesthesiology ◽

10.1097/00003643-200605001-00065 ◽

2006 ◽

Vol 23 (Supplement 38) ◽

pp. 22

Author(s):

E. Bignami ◽

G. Landoni ◽

G. Crescenzi ◽

G. Giardina ◽

F. Boroli ◽

...

Keyword(s):

Quality Of Life ◽

Cardiac Surgery ◽

Term Survival ◽

Long Term Survival

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Impact of Preoperative Functional Status on the Health-Related Quality of Life after Cardiac Surgery—A Prospective Study

10.1055/s-0039-1678852 ◽

2019 ◽

Author(s):

D. Joskowiak ◽

D. Meusel ◽

C. Hagl ◽

G. Juchem

Keyword(s):

Quality Of Life ◽

Cardiac Surgery ◽

Prospective Study ◽

Functional Status ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

A Prospective Study

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Spinal Cord Stimulation Is Effective in Management of Complex Regional Pain Syndrome I: Fact or Fiction

Neurosurgery ◽

10.1227/neu.0b013e3182181e60 ◽

2011 ◽

Vol 69 (3) ◽

pp. 566-580 ◽

Cited By ~ 71

Author(s):

Krishna Kumar ◽

Syed Rizvi ◽

Sharon Bishop Bnurs

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Functional Status ◽

Complex Regional Pain Syndrome ◽

Spinal Cord Stimulation ◽

Pain Syndrome ◽

Sf 36

Abstract BACKGROUND: Complex regional pain syndrome (CRPS) I is a debilitating neuropathic pain disorder characterized by burning pain and allodynia. Spinal cord stimulation (SCS) is effective in the treatment of CRPS I in the medium term but its long-term efficacy and ability to improve functional status remains controversial. OBJECTIVE: To evaluate the ability of SCS to improve pain, functional status, and quality of life in the long term. METHODS: We retrospectively analyzed 25 patients over a mean follow-up period of 88 months. The parameters for evaluation were visual analog scale (VAS), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), EuroQoL-5D (EQ-5D) and Short Form 36 (SF-36), and drug consumption. Evaluations were conducted at point of entry, 3 months, 12 months, and last follow-up at 88 months (mean). RESULTS: At baseline, the mean scores were VAS 8.4, ODI 70%, BDI 28, EQ-5D 0.30, and SF-36 24. In general, maximum improvement was recorded at follow-up at 3 months (VAS 4.8, ODI 45%, BDI 15, EQ-5D 0.57, and SF-36 45). At last follow-up, scores were 5.6, 50%, 19, 0.57, and 40, respectively. Despite some regression, at last follow-up benefits were maintained and found to be statistically significant (P < .001) compared with baseline. Medication usage declined. SCS did not prevent disease spread to other limbs. Best results were achieved in stage I CRPS I, patients under 40 years of age, and those receiving SCS within 1 year of disease onset. CONCLUSION: SCS improves pain, quality of life, and functional status over the long term and consequently merits early consideration in the treatment continuum.

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