Health-Related Quality of Life following Surgery for Native and Prosthetic Valve Infective Endocarditis

Abstract

Objectives: The objective of this study was to compare the long-term outcomes and health-related quality of life (HRQOL) of patients following surgery for infective native valve endocarditis (NVE) and prosthetic valve endocarditis (PVE). Methods: We retrospectively identified 633 consecutive patients who had undergone surgery for infective endocarditis at our center between January 2005 and October 2018. The patients were interviewed, and the SF-36 survey was used to assess the HRQOL of survivors. Propensity score matching (2:1) was performed with data from a German reference population. Multivariable analysis incorporated binary logistic regression using a forward stepwise (conditional) model. Results: The median age of the cohort was 67 (55–74) years, and 75.6% were male. Operative mortality was 13.7% in the NVE group and 21.6% in the PVE group (p = 0.010). The overall survival at 1 year was 88.0% and was comparable between the groups. The physical health summary scores were 49 (40–55) for the NVE patients and 45 (37–52) for the PVE patients (p = 0.043). The median mental health summary scores were 52 (35–57) and 49 (41–56), respectively (p = 0.961). On comparison of the HRQOL to the reference population, the physical health summary scores were comparable. However, significant differences were observed with regard to the mental health summary scores (p = 0.005). Conclusions: Our study shows that there are significant differences in the various domains of HRQOL, not only between NVE and PVE patients, but also in comparison to healthy individuals. In addition to preoperative health status, it is important to consider the patient’s expectations regarding surgery. Further prospective studies are required.

Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?

“…This should be accompanied by both reasonable follow-up survival and quality of life (QoL). Beyond perioperative survival prediction, a better understanding of the resulting QoL may help physicians, patients and families when facing the decision to consider surgery for IE [7][8][9].…”

“…However, due to the inherent systemic involvement of the disease, therapies addressed to grant survival may ultimately affect the long-term quality of life (QoL). This impact over QoL and burden of global functioning after IE has been seldomly explored in the existent literature, especially in the surgical population [7][8][9]. One of the available tools to assess QoL is the 36-Item Short Form Survey (SF-36) which evaluates the patients' physical, psychological and social performance [10,11].…”