Predictors of long-term HRQOL following cardiac surgery: a 5-year follow-up study

Quality of life, compliance with treatment, and challenges among patients undergoing cardiac intervention

Cardiovascular disease is the leading cause of mortality and disability worldwide, with important economic and quality-of-life implications. Effective treatment relies on drug adherence, which is impacted by a variety of factors; noncompliance increases morbidity, mortality, and healthcare costs. This study examines the quality of life, treatment adherence factors, and challenges that cardiac patients encounter during their treatment regimen. A cross-sectional study among 111 cardiac patients through purposive sampling was done at the All India Institute of Medical Sciences Deoghar between January 2023 and April 2024. Data on demographics, clinical characteristics, quality of life, and treatment adherence were gathered and analyzed using descriptive and inferential statistics while adhering to ethical guidelines and participant privacy. The research of 111 cardiac patients (76.6% male, mean age 56.45 years) revealed that the majority had undergone coronary artery bypass grafting surgery (83.8%), with many preferring private hospitals (58.6%). High medication adherence (82.0%) and regular follow-up (71.2%) were noted, although lifestyle improvements such as smoking cessation were less prevalent. Significant concerns in barriers were reported, including financial difficulties (35.1%) and accessibility of prescribed drugs (45.9%). Quality of life was generally reported as high, with most patients reporting no significant problem. This study reveals excellent adherence to medications and regular follow-up among participants. However, significant impediments such as financial constraints and accessibility issues for prescribed drugs continue to have an influence on treatment. Despite these limitations, patients often report a high quality of life, underscoring the complex interplay of medical, economic, and lifestyle aspects in cardiovascular health management.

Can Cardiac Surgery Lead to ICD-11 PTSD and Complex PTSD? Findings of a 5-year Follow-up Study

Cardiac surgery may lead to various neuropsychiatric conditions, including posttraumatic stress disorder (PTSD). The 11th revision of the International Classification of Diseases (ICD-11) included a new complex posttraumatic stress disorder (CPTSD) disorder in addition to PTSD. This study aimed to explore whether cardiac surgery could be associated with PTSD and CPTSD at a five-year follow-up after cardiac surgery. The study sample comprised 210 patients (mean age 67, 69.5% male) who had undergone cardiac surgery. The self-report International Trauma Questionnaire (ITQ) was used to assess ICD-11 PTSD and CPTSD. The Medical Outcomes Study 36 Item Short Form Health Survey (SF-36) questionnaire was used to measure health-related quality of life (HRQOL). We found 5.2% of cardiac surgery-related probable PTSD and CPTSD at a 5-year follow-up, 1.9% PTSD, and 3.3% CPTSD. Low HRQOL was associated with a high risk for PTSD/CPTSD at follow-up. The results showed that cardiac surgery might have a long-term effect on PTSD and CPTSD symptoms. Patients with low HRQOL are at higher risk of having PTSD/CPTSD risk. The study informs about the need for psychosocial interventions to reduce the impact of cardiac surgery on neuropsychiatric conditions and the improvement of HRQOL.

Quality of Life and Social Functioning of Patients After Cardiosurgical Interventions

The objective: to study the quality of life (QOL) and social functioning of patients who underwent cardiosurgery intervention (CSI) with the use of artificial circulation (AR) in the postoperative period, to determine and improve the system for further medical, psychological and social rehabilitation. Materials and methods. 700 patients who underwent CSI with the use of AR were treated at the Heart Institute of the Ministry of Health of Ukraine. 86 patients had cerebral infarction (CI), 217 patients with signs of postoperative encephalopathy, and 504 patients with signs of cognitive dysfunction. The level of QOL and social functioning in patients with this pathology was analyzed. Statistical analysis of differences in the quantitative values of indicators was performed using the nonparametric Mann-Whitney test. Results. It was found that patients after CSI had generally low levels of QOL in all fields, namely in the indicators of psychological (emotional) well-being, general perception of life, ability to work, physical well-being, personal realization, selfcare and independence; interpersonal interaction. The presence of ischemic and neurological complications in patients after CSI significantly reduces the QOL indicators in all areas, with differences in the quantitative values of such patients statistically significant (p<0,01) compared to the groups of patients without such complications. The most significant deterioration of QOL is found in patients with cerebral infarction in the postoperative period, slightly less significant – in patients with signs of postoperative encephalopathy, and the smallest changes – in patients with signs of cognitive dysfunction. Conclusions. The main task of modern cardiac surgery is not only to save the patient from death, but also to improve the quality of life (QOL). At the same time, patients after cardiac surgery are at risk of developing ischemic, neurological complications that significantly reduce QOL in all areas of life. That is why it is necessary to take into account the findings of the study in the development of treatment and rehabilitation programs and preventive measures for such patients.