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J Thorac Cardiovasc Surg 2000;120:505-512
© 2000 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment

From the Departments of Anaesthesiology,^a Cardiac Surgery,^b and Psychiatry,^c Ludwig-Maximilians University, Munich, Germany.

This study was supported by a grant from Hoffman-La Roche, Grenzach–Wyhlen, the Lilly Foundation, and the Techniker Krankenkasse, all in Germany.

Address for reprints: Christian Stoll, MD, Department of Anaesthesiology, Klinikum Grosshadern, Ludwig–Maximilians University, 81377 Munich, Germany (E-mail: christian.stoll{at}ana.med.uni-muenchen.de ).

Objectives: Health-related quality of life and patient satisfaction have become important end points in cardiac surgery. Post-traumatic stress disorder has been described in patients with life-threatening heart disease. In this study, we investigated the occurrence of post-traumatic stress disorder in a sample of patients after cardiac surgery and compared health-related quality of life and patient satisfaction between patients with and without evidence of post-traumatic stress disorder.
Methods: We studied 80 patients serially admitted to the intensive care unit after cardiac surgery (bypass grafting, n = 51; aortic valve replacement, n = 29). Health-related quality of life was assessed with the use of the SF-36 Health Status Questionnaire. Post-traumatic stress disorder was measured with a previously validated instrument (the Post-Traumatic Stress Syndrome 10-Questions Inventory), and 20 different aspects of life satisfaction were quantified on a scale ranging from 0 to 10. For measurements of health-related quality of life and post-traumatic stress disorder, age- and gender-comparable healthy individuals, as well as patients with cardiovascular diseases, served as control groups.
Results: Patients who had cardiac surgery described high life satisfaction summary scores (156 of a maximum of 200 points) and only small impairments in physical and mental SF-36 summary scores when compared with healthy control groups (median reduction 7.15, P < .05). Patients with evidence of post-traumatic stress disorder (n = 15) reported the lowest SF-36 mental health summary scores when compared with patients without stress disorder (38.3 vs 48.4, P = .004) and rated their life satisfaction lower (121.5 vs 162.0, P = .002).
Conclusions: Patients who have had cardiac surgery demonstrate a high life satisfaction with an acceptable degree of physical and mental health-related quality of life. Impairments in psychosocial function and life satisfaction were found in a subgroup of patients with evidence of post-traumatic stress disorder.

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