M. H. Mims3, K. Johnson2, S. J. Pereira1, C. T. Lewis1, K. W. Eudailey1, P. Vardas1, W. Holman1, J. K. Kirklin1, J. Davies1, R. Xie1 1University Of Alabama at Birmingham,Division Of Cardiothoracic Surgery, Department Of Surgery, School Of Medicine,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,School Of Medicine,Birmingham, Alabama, USA 3Auburn University,College Of Science And Mathematics,Auburn, ALABAMA, USA
Introduction: Aortic valve replacement (AVR) is commonly used to treat patients with aortic stenosis and/or regurgitation. Understanding patient-reported outcomes before and after AVR can assist with better informed patient-centered decision making and tailored care management. We aimed to assess pre-operative and post-operative quality of life (QoL) in adult AVR patients using various QoL measures and to identify a QoL measure with the greatest sensitivity.
Methods: AVR patients were prospectively enrolled to use a patient-engagement mobile application for receiving surgical self-care management educational materials and reporting patient-reported outcomes (PROs) measured by a generic (PROMIS Global10), a health utility (EQ-5D), and a heart disease-specific measure—the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). Descriptive statistics and exploratory analyses were conducted to evaluate these PROs at pre-operative, 30-day, and 90-day post-discharge periods.
Results: From July 2019 to May 2020, 130 AVR patients were enrolled. Among them, 75 patients completed the pre-operative, 59 completed the 30-day post-discharge, and 35 completed the 90-day post-discharge PROs. Improvements in QoL after AVR were detected by all the PRO measures. However, the domains of these QoL improvements differed across these measures. PROMIS Global 10 revealed reduced emotional problems, EQ-5D identified better self-care, and KCCQ-12 captured enhancements in all the domains, including physical limitation, symptom frequency, quality of life, social limitation, and the overall score (Table).
Conclusion: QoL enhancements after AVR are detected by generic, health utility, and disease-specific PRO measures. Though, a disease-specific measure—KCCQ-12—has the greatest sensitivity assessing various domains of QoL in AVR patients. Patient-centered decision making and care management strategies can be better tailored based on these disease-specific QoL measures.
