Evaluation of Quality Of Life after Cardiac Surgery in High-Risk Patients


  • Hanif Tabesh
  • Hossein Ahmadi Tafti
  • Sara Ameri
  • Arash Jalali
  • Narges Kashanivahid




Background: Conventionally, there is controversy over subjecting high-risk patients to cardiac operations, due to major postoperative complications. Higher survival rates and less morbidity as well as better quality of life can be good predictors of the outcome of surgery. This study evaluates the quality of life before and 12 months after cardiac operations on high-risk patients.

Methods: In this study, the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was used to separate high-risk patients from others. The quality of life was assessed using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) before surgery and one year afterward. Based on SF-36, the score for each of the eight different dimensions of the quality of life was quantified; and, their differences between pre-surgery and post-follow up period were analyzed.

Results: 126 high-risk patients were included in this study. The mean age of the patients was 64.29 ± 12.35 years. The median of EuroSCORE II score in these cases was 6.83 (6.04-25.98). The results reveal that the majority of the quality of life dimensions, except mental health, improved significantly after the follow-up period.

Conclusion: Cardiac surgery on high-risk patients can noticeably promote the different aspects of their quality of life; although, such improvements should be considered against surgical complications.


Aaronson NK, Muller M, Cohen PD, et al. 1998. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 51:1055-68.nBjorner JB, Thunedborg K, Kristensen TS, Modvig J, Bech P. 1998. The Danish SF-36 Health Survey: translation and preliminary validity studies. J Clin Epidemiol 51:991-9.nChalmers J, Pullan M, Fabri B, et al. 2013. Validation of EuroSCORE II in a modern cohort of patients undergoing cardiac surgery. Eur J Cardio-Thorac 43:688-94.nColak Z, Segotic I, Uzun S, Mazar M, Ivancan V, Majeric-Kogler V. 2008. Health related quality of life following cardiac surgery-correlation with EuroSCORE. Eur J Cardio-Thorac 33:72-6.nDi Dedda U, Pelissero G, Agnelli B, De Vincentiis C, Castelvecchio S, Ranucci M. 2013. Accuracy, calibration and clinical performance of the new EuroSCORE II risk stratification system. Eur J Cardio-Thorac 43:27-32.nGeissler HJ, Holzl P, Marohl S, et al. 2000. Risk stratification in heart surgery: comparison of six score systems. Eur J Cardio-Thorac 17:400-6.nGurler S, Gebhard A, Godehardt E, Boeken U, Feindt P, Gams E. 2003. EuroSCORE as a predictor for complications and outcome. Thorac Cardiov Surg 51:73-7.nGuyatt GH, Feeny DH, Patrick DL. 1993. Measuring health-related quality of life. Ann Intern Med 118:622-9.nLoponen P, Luther M, Nissinen J, et al. 2008. EuroSCORE predicts health-related quality of life after coronary artery bypass grafting. Interact Cardio-Thoracic Surg 7:564-8.nMontazeri A, Goshtasebi A, Vahdaninia M, Gandek B. 2005. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res 14:875-82.nNajafi M, Sheikhvatan M, Montazeri A, Abbasi SH, Sheikhfatollahi M. 2008. Quality of Life in Coronary Artery Disease: SF-36 Compared to WHOQOL-BREF. J Tehran Univ Heart Center 3:101-6.nNashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. 1999. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardio-Thorac 16:9-13.nNashef SA, Roques F, Michel P, et al. 2000. Coronary surgery in Europe: comparison of the national subsets of the European system for cardiac operative risk evaluation database. Eur J Cardio-Thorac 17:396-9.nNashef SA, Roques F, Hammill BG, et al. 2002. Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery. Eur J Cardio-Thorac 22:101-5.nNashef SA, Roques F, Sharples LD, et al. 2012. EuroSCORE II. Eur J Cardio-Thorac 41:734-45.nPeric V, Borzanovic M, Jovanovic A, Stolic R, Sovtic S, Trajkovic G. 2005. The relationship between EuroSCORE preoperative risk prediction and quality of life changes after coronary artery by-pass surgery. Interact Cardio-Thorac Surg 4:622-6.nPinna Pintor P, Bobbio M, Colangelo S, Veglia F, Marras R, Diena M. 2003. Can EuroSCORE predict direct costs of cardiac surgery? Eur J Cardio-Thorac 23:595-8.nPitkanen O, Niskanen M, Rehnberg S, Hippelainen M, Hynynen M. 2000. Intra-institutional prediction of outcome after cardiac surgery: comparison between a locally derived model and the EuroSCORE. Eur J Cardio-Thorac 18:703-10.nRiera M, Herrero J, Ibanez J, et al. 2011. Mid-term survival of patients undergoing major cardiac surgery. Rev Esp Cardiol 64:463-9.nRoques F, Michel P, Goldstone AR, Nashef SA. 2003. The logistic EuroSCORE. Eur Heart J 24:881-2.nRumsfeld JS, MaWhinney S, McCarthy M Jr, et al. 1999. Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery. JAMA 281:1298-303.nRumsfeld JS, Magid DJ, O'Brien M, et al. 2001. Changes in health-related quality of life following coronary artery bypass graft surgery. Ann Thorac Surg 72:2026-32.nSampalis J, Boukas S, Liberman M, Reid T, Dupuis G. 2001. Impact of waiting time on the quality of life of patients awaiting coronary artery bypass grafting. CMAJ 165:429-33.nToumpoulis IK, Anagnostopoulos CE, Swistel DG, DeRose JJ, Jr. 2005. Does EuroSCORE predict length of stay and specific postoperative complications after cardiac surgery? Eur J Cardio-Thorac 27:128-33.nYilmaz M, Saba D, Karal I, et al. 2007. Postoperative outcomes after off-pump coronary artery bypass grafting in EuroSCORE low- and high-risk women. Heart Surg Forum 10:482-6.n



How to Cite

Tabesh, H., Tafti, H. A., Ameri, S., Jalali, A., & Kashanivahid, N. (2015). Evaluation of Quality Of Life after Cardiac Surgery in High-Risk Patients. The Heart Surgery Forum, 17(6), E277-E281. https://doi.org/10.1532/HSF98.2014357