Cor Vasa 2003, 44(6):305-316

Long-term follow-up of patients undergoing cardiac surgical procedures

Jana Hyánková-Svobodová^1,*, Ladislava Harrerová², Jan Pirk³, Jaroslav Kramář⁴

¹ Datové centrum, Úsek informační a komunikační, Institut klinické a experimentální medicíny, Praha

² Kardiochirurgická klinika, Fakultní nemocnice, Hradec Králové

³ Klinika kardiovaskulární chirurgie, Institut klinické a experimentální medicíny

⁴ Oddělení cévní chirurgie, Nemocnice Na Homolce, Praha, Česká republika

Aim:
To map the development of the health status of patients undergoing cardiac surgical procedures.


Patients and method:
A total of 436 patients from three centers were followed for 2 to 3 years. Each center was evaluated separately. Two questionnaires were used for assessing patients' health status in this study: a follow-up questionnaire addressing issues of cardiology, and the SF-36 Quality of Life questionnaire.

Results:
Early mortality (30 days) was 5.1%; annualized mortality was 2% of the number of patients undergoing surgery; re-do surgery rate was up to 2.6% per year; percutaneous transluminal coronary angioplasty (PTCA) was performed in up to 2.6% per year, myocardial infarction (MI) at 1, 2, and 3 years occurred in 3.1, 1, and 2.4%, respectively; stroke or transient ischemic attack (TIA) occurred in 4.8-3.1% per year. Anginal pain decreased rapidly after cardiac surgical procedures, with a progressive rise within the next 2 postoperative years. There was an alarming postoperative increase in body mass index (BMI) as well as an increase in the number of smokers at 2 years after surgery. The pharmacotherapy employed was consistent with new trends. Overall, about 45% patients were hospitalized during the study period, significantly more during the first year, with cardiac, vascular and circulatory problems being the reason for hospitalization in more than 50% of patients. A surprising finding was that the TS (transformed scale) Score General Health in the SF-36 Quality of Life Questionnaire was highest at 3 months after surgery decreasing thereafter. In contrast, the TS Physical Summary Score increased rapidly at 1 year postoperatively not altering thereafter. The TS Score Role-Emotional and TS Score Bodily Pain improved gradually during the follow-up period.

Conclusion:
We are sure this project can play an important role as a guideline for prevention in and care of patients after cardiac surgical procedures. Further research is warranted to confirm or refute our results.

Keywords: Cardiac surgical procedures; Long-term follow-up; Follow-up questionnaire; SF-36 Quality of life questionnaire

Published: June 1, 2003  Show citation